Exploring the negative likelihood ratio and how it can be used to minimize false-positives in breast imaging

OBJECTIVE. This article describes the defnition and proposed utilization of negative likelihood ratios (NLRs) as statistical parameters in breast imaging. Examples with calculations are provided using BI-RADS category 4 subcategories. CONCLUSION. By auditing individual performance early and often against American College of Radiology benchmark positive predictive value ranges for the BI-RADS category 4 subcategories, and by fully understanding NLRs and their application in breast imaging, radiologists can minimize false-positive fndings and unnecessary biopsies.