Wish list for future features of breast MRI computer aided evaluation

Abstract

During the 2011 Radiological Society of North America meeting, this author approached one PACS (picture archiving and communication system) workstation manufacturer and asked if analysis of multiphasic examination was offered. It is perhaps shocking that this question was met with a puzzlement and immediate consultation between booth personnel, until finally; someone replied that this option was not yet available. Keep in mind that this is almost 20 years since Kaiser and colleagues first published on the importance of multiphasic breast MR examination [1]. The breast radiologist presented with interpretation of a breast MRI faces the daunting task of examining 1000–2000 images. Although current PACS workstations can easily display large imaging sets (e.g. during MR angiography), the current PACS workstation is not equipped to perform some basic tasks that are easily handled on a dedicated breast MRI workstation. Unfortunately, this requires that the radiologist switch to a dedicated workstation for examination of that breast MRI, then switch back to PACS afterwards to resume examination of the other imaging modalities associated with that patient. Further complicating this is the fact that digital mammography requires use of a high resolution workstation, not usually used for CT and MRI interpretation. The motivation for this presentation is to spur discussion between radiologists, physicists and equipment manufacturers in optimizing the workstation so as to improve radiologist efficiency and improve the quality of breast MRI interpretation.