Assessment of three different software systems in the evaluation of dynamic MRI of the breast

ObjectiveThe aim was to compare the diagnostic performance and handling of dynamic contrast-enhanced MRI of the breast with two commercial software solutions (“CADstream” and “3TP”) and one self-developed software system (“Mammatool”).Materials and methodsIdentical data sets of dynamic breast MRI from 21 patients were evaluated retrospectively with all three software systems. The exams were classified according to the BI-RADS® classification. The number of lesions in the parametric mapping was compared to histology or follow-up of more than 2 years. In addition, 25 quality criteria were judged by 3 independent investigators with a score from 0 to 5. Statistical analysis was performed to document the quality ranking of the different software systems.ResultsThere were 9 invasive carcinomas, one pure DCIS, one papilloma, one radial scar, three histologically proven changes due to mastopathy, one adenosis and two fibroadenomas. Additionally two patients with enhancing parenchyma followed with MRI for more than 3 years and one scar after breast conserving therapy were included. All malignant lesions were classified as BI-RADS® 4 or 5 using all software systems and showed significant enhancement in the parametric mapping. “CADstream” showed the best score on subjective quality criteria. “3TP” showed the lowest number of false-positive results. “Mammatool” produced the lowest number of benign tissues indicated with parametric overlay.ConclusionAll three software programs tested were adequate for sensitive and efficient assessment of dynamic MRI of the breast. Improvements in specificity may be achievable.