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Chapter 3: Case-based Clinical Decision Support for Breast Magnetic Resonance Imaging
Breast cancer is the most common cancer (excluding skin cancer) and the second most frequent cause of cancer death among women in the United States. Dynamic contrast-enhanced MRI (DCE-MRI) screening is recommended as an adjunct for mammography for high-risk women and is increasingly used as a key staging tool for newly diagnosed breast cancer.
Case-based clinical decision support (CDS) methods mimic natural
physicians’ reasoning for diagnosis by reading similar cases that have been previously reviewed and diagnosed. A case-based CDS for breast lesion diagnosis may help physicians to decide whether a queried case is likely to be malignant or benign, thus avoiding misinterpretation and preventing unnecessary biopsies.
Most of the case-based approaches in the published literature focus on breast cancer diagnosis based on mammogram and ultrasound images. Extending the case-based approach to DCE-MRI may improve the sensitivity and specificity. The challenge is to design an algorithm by taking more computer-calculated features into account to capture characteristics of malignant lesions. Additionally, there is also a challenge in obtaining the similarity relationship among cases for a case-based CDS system.
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