TY - JOUR
T1 - Ultrasound positive predictive values by BI-RADS categories 3–5 for solid masses
T2 - An independent reader study
AU - Stavros, A. Thomas
AU - Freitas, Andrea G.
AU - deMello, Giselle G.N.
AU - Barke, Lora
AU - McDonald, Dennis
AU - Kaske, Terese
AU - Wolverton, Ducly
AU - Honick, Arnold
AU - Stanzani, Daniela
AU - Padovan, Adriana H.
AU - Moura, Ana Paula C.
AU - de Campos, Marilia C.V.
N1 - Publisher Copyright:
© 2017, European Society of Radiology.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Objective: We assessed multiple readers’ positive predictive values (PPVs) for ACR BI-RADS 3, 4a, 4b, 4c and 5 masses on ultrasound (US) pre- and post-proposed guidelines. Methods: This retrospective, IRB-approved study included four American and four non-American readers who assigned BI-RADS categories for US images of 374 biopsy-proved masses. Readers were offered guidelines and re-classified the masses. We assessed readers’ abilities to achieve ACR benchmarks BI-RADS categories pre- and post-guidelines. Results: PPVs increased with BI-RADS category. The PPVs pre- and post-guidelines were 6.0% and 4.4% for category 3, 27.3% and 30.5% for category 4a, 49.9% and 51.5% for category 4b, 69.0% and 67.4% for category 4c, and 79.3% and 80.1% for category 5. Readers achieved the PPV benchmark for category 4c, but not for categories 3, 4a, 4b and 5, with no significant improvement after guidelines. Regular BI-RADS 4 subcategory users missed benchmarks by less than non-regular users. Conclusion: Pre- and post-guidelines, readers’ PPVs increased with BI-RADS categories, ACR PPV benchmarks were achieved in category 4c, missed in other categories, especially in the critical 4a subcategory, where the PPV was too high. BI-RADS 4 subcategory users performed better than non-users. Key points: • Readers failed to achieve benchmarks for BI-RADS 4 subcategories, especially 4a. • USA and Brazilian readers performed similarly in ACR BI-RADS 4 subcategorization. • Proposed guidelines did not improve overall, USA or Brazilian reader performance. • Regularly BI-RADS 4 subcategory users performed better than did non-users. • US features distinguished between benign and malignant, not BI-RADS 4 subcategories.
AB - Objective: We assessed multiple readers’ positive predictive values (PPVs) for ACR BI-RADS 3, 4a, 4b, 4c and 5 masses on ultrasound (US) pre- and post-proposed guidelines. Methods: This retrospective, IRB-approved study included four American and four non-American readers who assigned BI-RADS categories for US images of 374 biopsy-proved masses. Readers were offered guidelines and re-classified the masses. We assessed readers’ abilities to achieve ACR benchmarks BI-RADS categories pre- and post-guidelines. Results: PPVs increased with BI-RADS category. The PPVs pre- and post-guidelines were 6.0% and 4.4% for category 3, 27.3% and 30.5% for category 4a, 49.9% and 51.5% for category 4b, 69.0% and 67.4% for category 4c, and 79.3% and 80.1% for category 5. Readers achieved the PPV benchmark for category 4c, but not for categories 3, 4a, 4b and 5, with no significant improvement after guidelines. Regular BI-RADS 4 subcategory users missed benchmarks by less than non-regular users. Conclusion: Pre- and post-guidelines, readers’ PPVs increased with BI-RADS categories, ACR PPV benchmarks were achieved in category 4c, missed in other categories, especially in the critical 4a subcategory, where the PPV was too high. BI-RADS 4 subcategory users performed better than non-users. Key points: • Readers failed to achieve benchmarks for BI-RADS 4 subcategories, especially 4a. • USA and Brazilian readers performed similarly in ACR BI-RADS 4 subcategorization. • Proposed guidelines did not improve overall, USA or Brazilian reader performance. • Regularly BI-RADS 4 subcategory users performed better than did non-users. • US features distinguished between benign and malignant, not BI-RADS 4 subcategories.
KW - Breast cancer
KW - Breast neoplasms
KW - Breast ultrasonography
KW - Diagnostic, imaging
KW - Tumours, breast
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U2 - 10.1007/s00330-017-4835-7
DO - 10.1007/s00330-017-4835-7
M3 - Article
C2 - 28396996
AN - SCOPUS:85017250710
VL - 27
SP - 4307
EP - 4315
JO - European Radiology
JF - European Radiology
SN - 0938-7994
IS - 10
ER -