CAD in der Mammadiagnostik: Einsatz bei Mammografie und MRT

Zusammenfassung

In vielen Bereichen der diagnostischen Radiologie wird zunehmend der Einsatz von computerassistierten Diagnosesystemen (CAD-Systemen) geprüft. In der Mammografie ist dies von besonderem Interesse, da eine Zweitbefundung zeit- und kostenintensiv ist. Aufgrund der hohen Rate an falsch positiven Befunden ist jedoch derzeit der routinemäßige Einsatz der CAD-Systeme noch nicht in den klinischen Alltag eingezogen, sodass das Double Reading auch nicht durch einen Computer aktuell zu ersetzen ist. Es bleibt abzuwarten, ob die Technik in der Zukunft hier Verbesserungen bringt.

Abstract

Computer aided diagnosis systems (CAD-systems) are evaluated in different parts of diagnostic imaging. In breast imaging double reading which is time- and cost spending is necessary. Therefore a lot of studies evaluated the use of CAD-systems in mammography. However the rate of false-positives is too high to implement CAD-systems as double reader in routine work. In the future, improvements in this technique could perhaps change the performance of CAD-systems.

Key words

Computer aided diagnosis systems - diagnostic imaging - mammography

Kernaussagen

• Zur Qualitätssicherung der mammografischen Befundauswertung schreiben die Richtlinien der European Society of Mastology (EUSOMA) eine Doppelbefundung vor, wodurch die Sensitivität um ca. 15 % gesteigert werden kann.

• Eine mögliche Alternative zur ärztlichen Zweitbefundung könnten CAD-Systeme darstellen.

• Neben einer hohen Sensitivität besitzen die CAD-Systeme aber eine geringe Spezifität bei hoher Anzahl an falsch positiven Markierungen. Hier bleibt abzuwarten, ob in der Zukunft eine technische Verbesserung erzielt werden kann.

• In der MR-Mammografie soll der Radiologe durch die CAD-Systeme bei der Einordnung von Befunden in Benignität oder Malignität unterstützt werden. Auch sollen die Systeme die Kurvenanalyse automatisch in Form einer farbcodierten Analyse erledigen.

• Damit soll wiederum die Anzahl der falsch positiven Markierungen reduziert und die Zeit für die Interpretation der MR-Mammografie verkürzt werden.

• Aber auch hier bleibt der Radiologe und seine Erfahrung weiterhin das entscheidende Kriterium.

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