Breast screening programs using MRI: is there a role for computer-aided diagnosis?

Magnetic resonance mammography (MRM) has the highest sensitivity for detection of breast cancer. As opposed to x-ray mammography, MRM is unaffected by breast density, a condition fulfilled especially in younger women with dense breast tissue. Approximately 5–10% of all breast cancer cases will develop on the basis of genetic alterations. This high-risk group fulfils the breast density conditions above. Consequently, MRM has been used to screen for breast cancer in these individuals. This article seeks to assess the potential role of computer-aided diagnosis/detection (CAD) in a MRM screening setting. To do so, we describe screening MRI workflow conditions, possible CAD applications together with the use and limitations of available CAD systems. As differences in examination techniques present one major reason for the heterogeneity of reported results, we include our own detailed imaging protocol developed on the basis of more than 20 years of clinical MRM experience. We also provide a future perspective o...