Computerassistierte Diagnostik in der Magnetresonanz-Mammographie (MRM): Anwendung und Validierung der Software MT-Dyna (Fa. MeVis, Bremen)

Die kontrastmittel-gestützte dynamische MR-Mammographie (MRM) ist seit Ende der achtziger Jahre im klinischen Einsatz. In zahlreichen Studien wurde eine sehr gute Sensitivität dieser Methode bei der Detektion von Mammakarzinomen nachgewiesen. Probleme bereiten neben den hohen Untersuchungskosten u.a...

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Bibliographic Details
Main Author: Grebe, Philipp
Contributors: Klose, K.J. (Prof.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2005
Online Access:PDF Full Text
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Dynamic MR-mammography has been used clinically sence the 80ies. Many studies showed a high sensitivity for brerast-cancern of this method. Problems of MR-mammography are high costs, limitted specify and a lack of standardazation. Diagnosis-assisting software and standarisezed diagnostic criterea are expected to improve MR-mammography. this study`s purpose was to examine diagnostic accurance using the software MT-Dyna by MeVis, Bremen. Dynamic MR-Mammographies of 59 patients with suspect mammographic and sonographic findings were evaluated by an non-radiologist using MT-Dyna. Histology from biopsy served as gold-standard. Criterea for malignancy were high initial contrast enhancement, plateau and wash-out, ring-enhancement, spiculae. Three score-systems were applied on focal lesions (56 of 68 lesions). Sensitivity and specify of MT-Dyna-assisted diagnosis were 88,5% and 78,6% (while conventionell diagnosis by the radiologists were 92 and 71,4%). The three score systems showed good senstivity ( 92,3% vs 96% vs 96%) but low specify (25,8%, 48,4%, 38,7%). The analysis of the applied diagnostic criterea showed low specify of criterea discribing form and pattern of contrast-enhancement and the edge of the lesion. Dynamic Criterea such as the wash-out-sign influenced specify positvely. This study justifies clinical application of MT-Dyna. The application of dynamic criterea reinforced by MT-Dyna might have positive influence on specify.