Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Published online before print March 28, 2006, 10.1148/radiol.2392042127
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
2392042127v1
239/2/385    most recent
Right arrow Submit a response
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lazarus, E.
Right arrow Articles by Livingston, L. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lazarus, E.
Right arrow Articles by Livingston, L. S.
(Radiology 2006;239:385-391.)
© RSNA, 2006

Breast Imaging

BI-RADS Lexicon for US and Mammography: Interobserver Variability and Positive Predictive Value1

Elizabeth Lazarus, MD, Martha B. Mainiero, MD, Barbara Schepps, MD, Susan L. Koelliker, MD and Linda S. Livingston, MD

1 From the Department of Radiology, Rhode Island Hospital, Brown Medical School, 593 Eddy St, Providence, RI 02903. From the 2004 RSNA Annual Meeting. Received December 15, 2004; revision requested February 15, 2005; revision received April 17; accepted May 31; final version accepted July 18. Address correspondence to E.L. (e-mail: elazarus{at}lifespan.org).

Purpose: To retrospectively evaluate interobserver variability between breast radiologists by using terminology of the fourth edition of the Breast Imaging Reporting and Data System (BI-RADS) to categorize lesions on mammograms and sonograms and to retrospectively determine the positive predictive value (PPV) of BI-RADS categories 4a, 4b, and 4c.

Materials and Methods: Institutional review board approval was obtained; informed consent was not required. This study was HIPAA compliant. Ninety-four consecutive lesions in 91 women who underwent image-guided biopsy comprised 59 masses, 32 calcifications, and three masses with calcification. Five radiologists retrospectively reviewed these lesions. Each observer described each lesion with BI-RADS terminology and assigned a final BI-RADS category. Interobserver variability was assessed with the Cohen {kappa} statistic. A pathologic diagnosis was available for all 94 lesions; 30 (32%) were malignant and 64 (68%) were benign. Pathologic analysis of benign lesions was performed on tissue obtained with image-guided core-needle biopsy. In cases referred for excisional biopsy after needle biopsy because of atypia or discordance, final surgical pathologic analysis was used for correlation with imaging findings. PPV for category 4 or 5 lesions was determined for all readers combined.

Results: For ultrasonographic (US) descriptors, substantial agreement was obtained for lesion orientation, shape, and boundary ({kappa} = 0.61, 0.66, and 0.69, respectively). Moderate agreement was obtained for lesion margin and posterior acoustic features ({kappa} = 0.40 for both). Fair agreement was obtained for lesion echo pattern ({kappa} = 0.29). For mammographic descriptors, moderate agreement was obtained for mass shape, mass margin, and calcification distribution ({kappa} = 0.48, 0.48, and 0.50, respectively). Fair agreement was obtained for calcification description ({kappa} = 0.32). Slight agreement was obtained for mass density ({kappa} = 0.18). Fair agreement was obtained for final assessment category ({kappa} = 0.28). PPVs of BI-RADS category 4 and 5 assignments were as follows: category 4a, six (6%) of 102; category 4b, 17 (15%) of 110; category 4c, 48 (53%) of 91; and category 5, 71 (91%) of 78.

Conclusion: Interobserver agreement with the new BI-RADS terminology is good and validates the US lexicon. Subcategories 4a, 4b, and 4c are useful in predicting the likelihood of malignancy.

© RSNA, 2006




This article has been cited by other articles:


Home page
 Am. J. Roentgenol.Home page
S. J. Kim, E. Y. Ko, J. H. Shin, S. S. Kang, S. H. Mun, B.-K. Han, and E. Y. Cho
Application of Sonographic BI-RADS to Synchronous Breast Nodules Detected in Patients with Breast Cancer
Am. J. Roentgenol., September 1, 2008; 191(3): 653 - 658.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
E.-K. Kim, K. H. Ko, K. K. Oh, J. Y. Kwak, J. K. You, M. J. Kim, and B.-W. Park
Clinical Application of the BI-RADS Final Assessment to Breast Sonography in Conjunction with Mammography
Am. J. Roentgenol., May 1, 2008; 190(5): 1209 - 1215.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
D. L. Miglioretti, R. Smith-Bindman, L. Abraham, R. J. Brenner, P. A. Carney, E. J. A. Bowles, D. S. M. Buist, and J. G. Elmore
Radiologist Characteristics Associated With Interpretive Performance of Diagnostic Mammography
J Natl Cancer Inst, December 19, 2007; 99(24): 1854 - 1863.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
B. Mesurolle, L. Kadoch, M. El-Khoury, A. Lisbona, N. Dendukuri, and W. D. Foulkes
Sonographic Features of Breast Carcinoma Presenting as Masses in BRCA Gene Mutation Carriers
J. Ultrasound Med., June 1, 2007; 26(6): 817 - 824.
[Abstract] [Full Text] [PDF]

Home page
 radtechHome page
T. G. ODLE
Breast Ultrasound
Radiol. Technol., January 1, 2007; 78(3): 222M - 242M.
[Abstract] [Full Text] [PDF]

eLetters:

Read all eLetters

Is BI-RADS reproducible ?
Stefano Ciatto
Radiology Online, 2 Apr 2007 [Full text]

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
RADIOLOGY RADIOGRAPHICS RSNA JOURNALS ONLINE
Copyright © 2006 by the Radiological Society of North America.