Confirma®, pioneer and leader in application-specific CAD for magnetic resonance imaging (MRI), announced that a study by the Seattle Cancer Care Alliance and the University of Washington presented at RSNA 2007 suggests that the CADstream system's patented "worst curve" algorithm for analyzing kinetics may assist in determining malignancy.

The study, led by Dr. Lilian Wang, focused on the evaluation of kinetics and found that the most suspicious curve as identified by CADstream was significantly different between benign and malignant lesions. This supports the recommendation of the American College of Radiology's Breast Imaging Reporting and Database System (BI-RADS®) Atlas for breast MRI to report the "worst looking" curve. The study found that any washout enhancement was associated with malignancy in nearly half of lesions.

Dr. Wang's study ('MRI Detected Suspicious Breast Findings: Comparison of Kinetic Features Measured by Computer-aided Evaluation in Benign and Malignant Lesions') retrospectively examined 125 suspicious lesions (42 malignant, 83 benign) for which computer-aided-evaluation (CADstream) and subsequent image guided biopsy had been performed, out of a pool of 1538 breast MRI examinations conducted from November 2004 to November 2006.

The study compared three distinct computer-aided-evaluation kinetic features of suspicious breast MRI lesions to determine which could best predict benign or malignant outcomes. The study concluded that of the kinetic features analyzed only the most suspicious curve type as identified by CADstream was significantly different between benign and malignant lesions.

"Our findings are consistent with the ACR BI-RADS® Atlas recommendation for reporting the 'worst looking kinetic curve' of a lesion with breast MRI," said Lilian Wang., M.D., Radiology Resident at the Seattle Cancer Care Alliance and University of Washington. Other researchers on the study were Wendy DeMartini, M.D.; Constance Lehman, M.D.; and Sue Peacock, M.Sc.

CADstream for Breast MRI

The CADstream system automates analysis, reporting and interventional planning of studies and promotes standardization with the incorporation of the American College of Radiology's Breast Imaging Reporting and Database System (BI-RADS®), which guides the breast cancer diagnostic routine and decision-making process.

Confirma's next-generation version of CADstream for breast MRI, launched at RSNA, includes a new customizable BI-RADS-centric user interface that accommodates a variety of user experience levels. Additional CADstream enhancements include improved 3D renderings and tools for morphology reporting.

CADstream is currently in use by thousands of physician users and hundreds of breast MRI programs. The July 2007 issue of Radiology published research from the University of Washington and Seattle Cancer Care Alliance indicating that CAD for breast MRI may improve standardization, and the analysis of benign and malignant lesions. CADstream was the CAD for breast MRI system used in this study.

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