Observer variability of Breast Imaging Reporting and Data System (BI-RADS) for breast ultrasound

Hye Jeong Lee, Eunkyung Kim, minjung Kim, Ji Hyun Youk, Ji Young Lee, Dae Ryong Kang, Ki Keun Oh

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate inter- and intra-observer variabilities in breast sonographic feature analysis and management, using the fourth edition of the Breast Imaging Reporting and Data System (BI-RADS). Materials and methods: We included 136 patients with 150 breast lesions who underwent breast ultrasound (US) and ultrasound-guided core needle biopsy. A pathological diagnosis was available for all 150 lesions: 77 (51%) malignant and 73 (49%) benign. Four radiologists retrospectively reviewed sonographic images of lesions twice within an 8-week interval. The observers described each lesion, using BI-RADS descriptors and final assessment. Inter- and intra-observer variabilities were assessed with Cohen's kappa statistic. Positive predictive value and negative predictive value (NPV) for final assessment were also calculated. Results: For inter-observer agreements for sonographic descriptors, substantial agreement for lesion calcification and final assessment (κ = 0.61 for both), moderate agreement for lesion shape, orientation, boundary, and posterior acoustic features (κ = 0.49, 0.56, 0.59, and 0.49, respectively), and fair agreement for lesion margin and echo pattern (κ = 0.33 and 0.37, respectively) were obtained. For intra-observer agreement, substantial to perfect agreement was found for almost all lesion descriptors and final assessments. NPV for final assessment category 3 was 95%. Positive predictive value (PPV) for final assessment categorized as 4 or 5 were as follows: category 4a, 26%; category 4b, 89%; category 4c, 90%; and category 5, 97%. Conclusion: Because inter- and intra-observer agreement with the BI-RADS lexicon for US is good, the use of BI-RADS lexicon can provide accurate and consistent description and assessment for breast US.

Original languageEnglish
Pages (from-to)293-298
Number of pages6
JournalEuropean Journal of Radiology
Volume65
Issue number2
DOIs
Publication statusPublished - 2008 Feb 1

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Information Systems
Breast
Observer Variation
Large-Core Needle Biopsy
Acoustics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Lee, Hye Jeong ; Kim, Eunkyung ; Kim, minjung ; Youk, Ji Hyun ; Lee, Ji Young ; Kang, Dae Ryong ; Oh, Ki Keun. / Observer variability of Breast Imaging Reporting and Data System (BI-RADS) for breast ultrasound. In: European Journal of Radiology. 2008 ; Vol. 65, No. 2. pp. 293-298.
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abstract = "Purpose: To evaluate inter- and intra-observer variabilities in breast sonographic feature analysis and management, using the fourth edition of the Breast Imaging Reporting and Data System (BI-RADS). Materials and methods: We included 136 patients with 150 breast lesions who underwent breast ultrasound (US) and ultrasound-guided core needle biopsy. A pathological diagnosis was available for all 150 lesions: 77 (51{\%}) malignant and 73 (49{\%}) benign. Four radiologists retrospectively reviewed sonographic images of lesions twice within an 8-week interval. The observers described each lesion, using BI-RADS descriptors and final assessment. Inter- and intra-observer variabilities were assessed with Cohen's kappa statistic. Positive predictive value and negative predictive value (NPV) for final assessment were also calculated. Results: For inter-observer agreements for sonographic descriptors, substantial agreement for lesion calcification and final assessment (κ = 0.61 for both), moderate agreement for lesion shape, orientation, boundary, and posterior acoustic features (κ = 0.49, 0.56, 0.59, and 0.49, respectively), and fair agreement for lesion margin and echo pattern (κ = 0.33 and 0.37, respectively) were obtained. For intra-observer agreement, substantial to perfect agreement was found for almost all lesion descriptors and final assessments. NPV for final assessment category 3 was 95{\%}. Positive predictive value (PPV) for final assessment categorized as 4 or 5 were as follows: category 4a, 26{\%}; category 4b, 89{\%}; category 4c, 90{\%}; and category 5, 97{\%}. Conclusion: Because inter- and intra-observer agreement with the BI-RADS lexicon for US is good, the use of BI-RADS lexicon can provide accurate and consistent description and assessment for breast US.",
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Observer variability of Breast Imaging Reporting and Data System (BI-RADS) for breast ultrasound. / Lee, Hye Jeong; Kim, Eunkyung; Kim, minjung; Youk, Ji Hyun; Lee, Ji Young; Kang, Dae Ryong; Oh, Ki Keun.

In: European Journal of Radiology, Vol. 65, No. 2, 01.02.2008, p. 293-298.

Research output: Contribution to journalArticle

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N2 - Purpose: To evaluate inter- and intra-observer variabilities in breast sonographic feature analysis and management, using the fourth edition of the Breast Imaging Reporting and Data System (BI-RADS). Materials and methods: We included 136 patients with 150 breast lesions who underwent breast ultrasound (US) and ultrasound-guided core needle biopsy. A pathological diagnosis was available for all 150 lesions: 77 (51%) malignant and 73 (49%) benign. Four radiologists retrospectively reviewed sonographic images of lesions twice within an 8-week interval. The observers described each lesion, using BI-RADS descriptors and final assessment. Inter- and intra-observer variabilities were assessed with Cohen's kappa statistic. Positive predictive value and negative predictive value (NPV) for final assessment were also calculated. Results: For inter-observer agreements for sonographic descriptors, substantial agreement for lesion calcification and final assessment (κ = 0.61 for both), moderate agreement for lesion shape, orientation, boundary, and posterior acoustic features (κ = 0.49, 0.56, 0.59, and 0.49, respectively), and fair agreement for lesion margin and echo pattern (κ = 0.33 and 0.37, respectively) were obtained. For intra-observer agreement, substantial to perfect agreement was found for almost all lesion descriptors and final assessments. NPV for final assessment category 3 was 95%. Positive predictive value (PPV) for final assessment categorized as 4 or 5 were as follows: category 4a, 26%; category 4b, 89%; category 4c, 90%; and category 5, 97%. Conclusion: Because inter- and intra-observer agreement with the BI-RADS lexicon for US is good, the use of BI-RADS lexicon can provide accurate and consistent description and assessment for breast US.

AB - Purpose: To evaluate inter- and intra-observer variabilities in breast sonographic feature analysis and management, using the fourth edition of the Breast Imaging Reporting and Data System (BI-RADS). Materials and methods: We included 136 patients with 150 breast lesions who underwent breast ultrasound (US) and ultrasound-guided core needle biopsy. A pathological diagnosis was available for all 150 lesions: 77 (51%) malignant and 73 (49%) benign. Four radiologists retrospectively reviewed sonographic images of lesions twice within an 8-week interval. The observers described each lesion, using BI-RADS descriptors and final assessment. Inter- and intra-observer variabilities were assessed with Cohen's kappa statistic. Positive predictive value and negative predictive value (NPV) for final assessment were also calculated. Results: For inter-observer agreements for sonographic descriptors, substantial agreement for lesion calcification and final assessment (κ = 0.61 for both), moderate agreement for lesion shape, orientation, boundary, and posterior acoustic features (κ = 0.49, 0.56, 0.59, and 0.49, respectively), and fair agreement for lesion margin and echo pattern (κ = 0.33 and 0.37, respectively) were obtained. For intra-observer agreement, substantial to perfect agreement was found for almost all lesion descriptors and final assessments. NPV for final assessment category 3 was 95%. Positive predictive value (PPV) for final assessment categorized as 4 or 5 were as follows: category 4a, 26%; category 4b, 89%; category 4c, 90%; and category 5, 97%. Conclusion: Because inter- and intra-observer agreement with the BI-RADS lexicon for US is good, the use of BI-RADS lexicon can provide accurate and consistent description and assessment for breast US.

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