CAD: Expanding Applications and Accuracy

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While researchers outlined the clinical might and cost-effectiveness of mammography CAD in presentations at this year's RSNA, a growing number of vendors showed off the latest and greatest CAD technology. CAD has come far in just a few short years-progressing from its roots in analog mammography to digital mammography and MRI and now including CAD for x-ray and CT chest images and CT colonography. These days, 25 to 30 percent of all screening mammograms are interpreted with the help of CAD, and new research indicates that the addition of CAD to screening mammography is cost-effective. So it's no surprise that several new vendors threw their hats into the CAD ring and launched mammography CAD products at the show-with a few more poised to hit the streets in the next year. And established companies continue to carve out their space with stratified solutions targeted for various segments of the market from low volume to high volume sites.

MRI CAD systems demonstrated their productivity and clinical value, and ultrasound bounced into the CAD realm with the first CAD system for breast ultrasound expected to hit the US market in 2005.

Healthcare facilities thinking about CAD for lung lesions have two choices - x-ray based CAD and CT chest CAD, with makers of CT-based systems pointing to workflow enhancements made possible with CAD-aided navigation of the volumes of CT data. And CT colon CAD, a relative of lung CT CAD technology, is available to help radiologists sort through the volumes of data created by CT colonographies and highlight areas for further review.

(Note: companies appear in alphabetical order.)


3TP Imaging Sciences showed its 3TP breast imaging enhancement software for MRI workflow and launched its Total Solution for Prostate MR Imaging.

3TP breast imaging software automatically applies a CAD algorithm to breast MRI studies, creates DICOM 3 images and sends the images to PACS and viewing stations. Clinical studies indicate 96 percent sensitivity and 82 percent specificity for solid lesions, the company said. Additional capabilities include MIPS, motion correction, subtraction and 3D volume. The system is compatible with MRIs of 1.0T or greater and any DICOM 3 MRI system or workstation.

Total Solution for Prostate Imaging is a computer analysis program for prostate staging. It incorporates a scientifically validated contrast enhancement method and correlates images to pathology results, 3TP said. The technology is DICOM 3 compatible and integrates color images with PACS.


Agfa Corp. announced plans to integrate and distribute Medicsight's Computer Assisted Reading (CAR) software in its solutions for radiology and other clinical specialties.

The two companies signed a letter of intent that outlines plans to integrate Medicsight's Colon CAR, Lung CAR and Heart Screen software into Agfa's solutions for radiology and clinical specialties on the global market. Moreover, Agfa will be granted limited exclusivity to distribute the integrated solutions. The research departments of Agfa and Medicsight will work closely together to develop completely integrated solutions, assisting radiologists in detecting and accurately measuring colon polyps, lung lesions and coronary artery calcifications.

During RSNA, Agfa demonstrated both Lung CAR and Colon CAR software (which both recently gained FDA marketing clearance) at its booth.


CADimas shared its works in progress breast MRI CAD system, CADimas. The CADimas breast MRI CAD system discriminates benign from malignant lesions using a variety of computer and interpreted features, including kinetics, intensity, morphology and texture, CADimas said. FDA approval is anticipated in 2006. The system incorporates a computer-intensity feature, which has been found to be particularly useful for identifying cancers, such as DCIS (ductal carcinoma in situ), that could be missed using other breast MRI CAD systems. The company plans on making this feature available as an add-on module to existing breast MRI CAD systems within the next year.


Cedara Software unveiled B-CAD breast ultrasound CAD, which the company describes as an image analysis scheme to determine more than 20 sonographic lesion characteristics and an advanced decision engine to help identify benign and malignant lesions. B-CAD can provide the radiologist with CAD information on the clinically relevant characteristics and features of the target of interest as well as the probability that a target lesion is either