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

 Hye-Jeong Lee  ;  Eun-Kyung Kim  ;  Min Jung Kim  ;  Ji Hyun Youk  ;  Ji Young Lee  ;  Dae Ryong Kang  ;  Ki Keun Oh 
 EUROPEAN JOURNAL OF RADIOLOGY, Vol.65(2) : 293-298, 2008 
Journal Title
Issue Date
Adult ; Aged ; Biopsy, Needle ; Breast Neoplasms/diagnostic imaging* ; Female ; Humans ; Image Interpretation, Computer-Assisted* ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Sensitivity and Specificity ; Ultrasonography, Mammary*
Breast ultrasound ; BI-RADS lexicon ; Inter-observer variability ; Intra-observer variability
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 (kappa=0.61 for both), moderate agreement for lesion shape, orientation, boundary, and posterior acoustic features (kappa=0.49, 0.56, 0.59, and 0.49, respectively), and fair agreement for lesion margin and echo pattern (kappa=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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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kang, Dae Ryong(강대용)
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Oh, Ki Keun(오기근)
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
Lee, Ji Young(이지영)
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
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