Interobserver agreement in breast radiological density attribution according to BI-RADS quantitative classification
Interobserver agreement in breast radiological density attribution according to BI-RADS quantitative classification
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DOI：
10.1007/s11547-011-0777-3
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发表时间：
2012-06-01
影响因子：
8.9
通讯作者：
Ciatto, S.
中科院分区：
文献类型：
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作者：
Bernardi, D.;Pellegrini, M.;Ciatto, S.
作者试图根据定量乳腺成像报告和数据系统（BI-RADS）标准评估观察者对乳腺X线摄影密度分类的一致性。根据kappa统计量确定观察者间一致性，调整4类（D1 vs. D2 vs. D3 vs. D4）或2类（D1-2 vs. D3-4）的机会一致性。在先前的研究中，12名读者在同一组数据上接受了测试，我们也评估了他们之间的一致性。当两两比较时，6名读者表现出良好的一致性[在4个类别的基础上一致性是实质性的（kappa=0.60-0.80）13对，几乎完美（kappa > 0.80）;在两类的基础上，12对协议是实质性的，3对协议几乎是完美的）或与专家组相比，（在四个类别的基础上，六位读者中有五位基本同意，一位几乎完全同意;在两个类别的基础上，所有读者的一致性是实质性的）。与以前的研究一致，根据BI-RADS定量标准对乳腺X线摄影密度进行视觉分类在读片者中具有高度可重复性;然而，归因于“致密乳腺”，（BI-RADS D3-4）类别，这可能被采纳为不同筛选方案的决定因素（如辅助超声检查或每年间隔）在读片者之间存在差异（范围6-15%）。对照研究应进行比较视觉与计算机密度类别归因，后者可能是一个更好的选择，由于其绝对的再现性。
The authors sought to assess interobserver agreement in classifying mammography density according to quantitative Breast Imaging Reporting and Data System (BI-RADS) criteria.Six expert mammography readers were tested on a set of 100 mammograms. Interobserver agreement was determined according to the kappa statistic, adjusting for chance agreement, on a four-category (D1 vs. D2 vs. D3 vs. D4) or two-category (D1-2 vs. D3-4) basis. Agreement with a panel of 12 readers who had been tested on the same set in a previous study was also assessed.The six readers showed good agreement when compared in pairs [agreement on a four-category basis was substantial (kappa=0.60-0.80) for 13 pairs and almost perfect (kappa > 0.80) for two pairs); agreement on a two-category basis was substantial for 12 pairs and almost perfect for three pairs) or compared with the panel (on a four-category basis, agreement was substantial for five of six readers and almost perfect for one; on a two-category basis, agreement was substantial for all readers).In agreement with previous studies, visual classification of mammography density according to BI-RADS quantitative criteria was highly reproducible among readers; nevertheless, attribution to the "dense breast" (BI-RADS D3-4) category, which might be adopted as a determinant of different screening protocols (such as adjunct ultrasonography or yearly interval) varied among readers (range 6-15%). Controlled studies should be performed comparing visual with computer-density category attribution, the latter possibly being a better alternative due to its absolute reproducibility.