Comparison of breast density assessments according to BI-RADS 4th and 5th editions and experience level
Comparison of breast density assessments according to BI-RADS 4th and 5th editions and experience level
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DOI：
10.1177/2058460120937381
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发表时间：
2020-07-01
影响因子：
1.1
通讯作者：
Inci, Ercan
中科院分区：
文献类型：
--
作者：
Gemici, Aysegul Akdogan;Bayram, Ersoy;Inci, Ercan
背景：乳腺密度是一个重要的变量，可以改变乳腺摄影的灵敏度。可以使用美国放射学会（ACR）推荐的第4版和第5版乳腺成像和报告数据系统（BI-RADS）进行分析。目的：定义具有不同经验水平的阅片者使用两个版本的BI-RADS进行乳腺密度分配的阅片者内和阅片者间一致性水平。材料和方法：330名女性的乳腺密度评估由两名具有不同经验水平的阅片者（一名乳腺放射科医生和一名住院医师）进行。每位读者独立定义乳房密度四次-两次使用第4版，两次使用第5版。评估进行了分析，四个和两个类别scales.Results：内部的读者协议的乳腺放射科医生的第4和第5版的BI-RADS几乎是完美的（k = 0.90和k = 0.87，分别）。居民有类似的结果（k = 0.88和k = 0.87，分别）。乳腺放射科医师和住院医师对第4版和第5版BI-RADS的一致性是实质性的（分别为k = 0.70和k = 0.63）。两种版本的BI-RADS在致密和非致密两类量表分析中差异有统计学意义（McNemar's test，P < 0.001）。结论：尽管两种版本的BI-RADS都有较高的阅片者内和阅片者间一致性，但使用第5版时，致密乳房的女性比例增加，差异有统计学意义。在所有分析中，未发现读片者的经验水平存在差异。
Background: Breast density is an important variable that can change the sensitivity of mammography. It can be analyzed with using the 4th and 5th editions of the Breast Imaging and Reporting Data System (BI-RADS) recommendations from the American College of Radiology (ACR).Purpose: To define the intra- and inter-reader agreement levels of breast density assignments performed by readers with different experience levels using two versions of BI-RADS.Material and Methods: The breast density assessments of 330 women were conducted by two readers with different levels of experience (one breast radiologist and one resident). Each reader independently defined the breast density four times-twice using the 4th edition and twice using the 5th edition. Assessments were analyzed on four- and two-category scales.Results: The intra-reader agreement of the breast radiologist for the 4th and 5th editions of BI-RADS was almost perfect (k = 0.90 and k = 0.87, respectively.) The resident had similar results (k = 0.88 and k = 0.87, respectively). The agreement between the breast radiologist and resident for the 4th and 5th edition of BI-RADS was substantial (k = 0.70 and k = 0.63, respectively). There was a statistically significant difference with the two-category scale analysis between the dense and non-dense for both readers and versions of BI-RADS (McNemar's test, P < 0.001).Conclusion: Although there were high intra- and inter-reader agreement levels when using both versions, the percentage of women having dense breasts increased when using the 5th edition, and the difference was statistically significant. There were no differences found with regard to the readers' level of experience in all analyses.