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Computer-aided detection, including computer algorithm analysis of MRI image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation, breast MRI (List separately in addition to code for primar

CPT4 code

Name of the Procedure:

Computer-aided detection (CAD) with pharmacokinetic analysis, breast MRI

Summary

Computer-aided detection (CAD) for breast MRI involves the use of computer algorithms to analyze MRI image data to detect and characterize lesions in the breast. This analysis includes pharmacokinetic analysis, where the contrast agent's behavior is studied to help identify abnormalities. A physician then reviews the results for final interpretation.

Purpose

CAD for breast MRI helps in the early detection and characterization of breast lesions, including cancer. It aims to improve diagnostic accuracy and assist physicians in making informed decisions about patient care.

Indications

  • Individuals with a high risk of breast cancer.
  • Patients with dense breast tissue where mammograms may not be as effective.
  • Suspected abnormalities found in mammograms or ultrasounds.
  • Monitoring the progress of diagnosed breast conditions.
  • Evaluating the effectiveness of breast cancer treatments.

Preparation

  • Fasting is not generally required.
  • Patients should inform their doctor of any allergies, especially to contrast agents.
  • Avoid applying lotions, deodorants, or powders to the breast area.
  • Wear comfortable clothing and remove any metal objects.
  • Previous imaging studies (mammograms, ultrasounds) should be brought to the appointment if applicable.

Procedure Description

  1. The patient will lie face down on a specialized MRI table.
  2. Breast coils will be positioned around the breasts to capture detailed images.
  3. An intravenous (IV) line is inserted to administer a contrast agent.
  4. The MRI scan is performed, taking multiple images of the breast.
  5. Computer algorithms analyze the MRI data, focusing on lesion detection and pharmacokinetic characteristics of the contrast agent.
  6. A radiologist reviews the CAD results for interpretation and provides a detailed report.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Breast MRI with CAD is usually performed in a hospital or specialized imaging center.

Personnel

  • Radiologist
  • MRI Technologist
  • Nurses (if IV contrast is administered)
  • Referring physician (for follow-up and consultation)

Risks and Complications

  • Allergic reactions to the contrast agent (rare).
  • Minor discomfort or bruising at the IV insertion site.
  • Claustrophobia during the MRI scan.
  • False positives or false negatives, leading to additional testing.

Benefits

  • Enhanced detection and characterization of breast lesions.
  • Improved diagnostic accuracy for earlier intervention.
  • Non-invasive and detailed imaging without radiation exposure.

Recovery

  • Patients can generally resume normal activities immediately after the procedure.
  • Drinking plenty of fluids to help flush the contrast agent from the body.
  • Follow-up appointments may be scheduled to discuss results with a physician.

Alternatives

  • Conventional mammography
  • Breast ultrasound
  • Positron Emission Tomography (PET) scans
  • Breast biopsies
  • Each alternative has its pros and cons; breast MRI with CAD is often preferred for detailed evaluation in high-risk patients.

Patient Experience

During the procedure, the patient will need to remain still to ensure clear images. They may hear loud noises from the MRI machine and will be given earplugs or headphones for comfort. Post-procedure, slight discomfort from the IV site may occur, but overall, the experience is typically well-tolerated, and pain management is rarely needed.

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