Mastodawn

European Radiology Nov 28, 2024

A study on inter-reader agreement of the breast imaging reporting and data system (BI-RADS) contrast-enhanced #mammography (CEM) lexicon found moderate to substantial agreement for most features, with lower agreement for non-mass enhancement and enhancing asymmetry. (Calogero Zarcaro et al.)

#EuropeanRadiology #BIRADS

🔗 https://buff.ly/3OqsjpP

Inter-reader agreement of the BI-RADS CEM lexicon - European Radiology

Purpose The purpose of this study was to assess the inter-reader agreement of the breast imaging reporting and data system (BI-RADS) contrast-enhanced mammography (CEM) lexicon. Materials and methods In this IRB-approved, single-center, retrospective study, three breast radiologists, each with different levels of experience, reviewed 462 lesions in 421 routine clinical CEM according to the fifth edition of the BI-RADS lexicon for mammography and to the first version of the BI-RADS lexicon for CEM. Readers were blinded to patient outcomes and evaluated breast and lesion features on low-energy (LE) images (breast density, type of lesion, associated architectural distortion), lesion features on recombined (RC) images (type of enhancement, characteristic of mass enhancement, non-mass enhancement or enhancing asymmetry), and provided a final BI-RADS assessment. The inter-reader agreement was calculated for each evaluated feature using Fleiss’ kappa coefficient. Sensitivity and specificity were calculated. Results The inter-reader agreement was moderate to substantial for breast density (ĸ = 0.569), type of lesion on LE images (ĸ = 0.654), and type of enhancement (ĸ = 0.664). There was a moderate to substantial agreement on CEM mass enhancement descriptors. The agreement was fair to moderate for non-mass enhancement and enhancing asymmetry descriptors. Inter-reader agreement for LE and LE with RC BI-RADS assessment was moderate (ĸ = 0.421) and fair (ĸ = 0.364). Diagnostic performance was good and comparable for all readers. Conclusion Inter-reader agreement of the CEM lexicon was moderate to substantial for most features. There was a low agreement for some RC descriptors, such as non-mass enhancement and enhancing asymmetry, and BI-RADS assessment, but this did not impact the diagnostic performance. Key Points Question Data on the reproducibility and inter-reader agreement for the first version of the BI-RADS lexicon dedicated to CEM are missing. Finding The inter-reader agreement for the lexicon was overall substantial to moderate, but it was lower for the descriptors for non-mass enhancement and enhancing asymmetry. Clinical relevance A common lexicon simplifies communication between specialists in clinical practice. The good inter-reader agreement confirms the effectiveness of the CEM-BIRADS in ensuring consistent communication. Detailed definitions of some descriptors (non-mass, enhancing asymmetry) are needed to ensure higher agreements.

SpringerLink

Insights Into Imaging Jun 12, 2024

This #InsightsIntoImaging study from Bianca den Dekker found that supplemental 3D automated breast ultrasound in the work-up of #BIRADS o recalls may miss over a quarter of cancers detected using other methods and should be used to omit biopsy.

#BreastCancer

🔗 https://buff.ly/4aQ9ViY

Diagnostic accuracy of supplemental three-dimensional breast ultrasound in the work-up of BI-RADS 0 screening recalls - Insights into Imaging

Objective To evaluate the diagnostic accuracy of supplemental 3D automated breast ultrasound (ABUS) in the diagnostic work-up of BI-RADS 0 recalls. We hypothesized that 3D ABUS may reduce the benign biopsy rate. Materials and methods In this prospective multicenter diagnostic study, screening participants recalled after a BI-RADS 0 result underwent bilateral 3D ABUS supplemental to usual care: digital breast tomosynthesis (DBT) and targeted hand-held ultrasound (HHUS). Sensitivity, specificity, positive predictive value, and negative predictive value of 3D ABUS, and DBT plus HHUS, were calculated. New 3D ABUS findings and changes of management (biopsy or additional imaging) were recorded. Results A total of 501 women (median age 55 years, IQR [51–64]) with 525 BI-RADS 0 lesions were included between April 2018 and March 2020. Cancer was diagnosed in 45 patients. 3D ABUS sensitivity was 72.1% (95% CI [57.2–83.4%]), specificity 84.4% (95% CI [80.8–87.4%]), PPV 29.2% (95% CI [21.4–38.5%]), and NPV 97.1% 95.0–98.4%). Sensitivity of DBT plus HHUS was 100% (95% CI [90.2–100%]), specificity 71.4% (95% CI [67.2–75.2%]), PPV 23.8% (95% CI [18.1–30.5%]) and NPV 100% (95% CI [98.7–100%]). Twelve out of 43 (27.9%) malignancies in BI-RADS 0 lesions were missed on 3D ABUS, despite being detected on DBT and/or HHUS. Supplemental 3D ABUS resulted in the detection of 57 new lesions and six extra biopsy procedures, all were benign. Conclusion 3D ABUS in the diagnostic work-up of BI-RADS 0 recalls may miss over a quarter of cancers detected with HHUS and/or DBT and should not be used to omit biopsy. Supplemental 3D ABUS increases the benign biopsy rate. Trial registration Dutch Trial Register, available via https://www.onderzoekmetmensen.nl/en/trial/29659 Critical relevance statement Supplemental 3D automated breast ultrasound in the work-up of BI-RADS 0 recalls may miss over a quarter of cancers detected with other methods and should not be used to omit biopsy; ABUS findings did increase benign biopsy rate. Key Points Automated breast ultrasound (ABUS) may miss over 25% of cancers detectable by alternative methods. Don’t rely solely on 3D ABUS to assess indication for biopsy. New findings with supplemental 3D ABUS increase the benign biopsy rate. Graphical Abstract

SpringerOpen

Zougla.gr Apr 22, 2024

#BIRADS Μαστογραφία: Τι σημαίνει BIRADS; https://www.zougla.gr/femina/mastografia-ti-simainei-birads/?utm_source=dlvr.it&utm_medium=mastodon

Μαστογραφία: Τι σημαίνει BIRADS; - Zougla

Στο σύστημα BIRADS ή BI-RADS (Breast Imaging Reporting and Data System) τα ευρήματα ταξινομούνται σε 6 κατηγορίες:

Zougla

Insights Into Imaging Feb 23, 2024

Educational Review: Contrast-enhanced mammography #BIRADS - a case-based approach to radiology reporting. (Luca Nicosia et al.)

#InsightsIntoImaging

🔗 https://buff.ly/3I1uz3W

Contrast-enhanced mammography BI-RADS: a case-based approach to radiology reporting - Insights into Imaging

Contrast-enhanced mammography (CEM) is a relatively recent diagnostic technique increasingly being utilized in clinical practice. Until recently, there was a lack of standardized reporting for CEM findings. However, this has changed with the publication of a supplement in the Breast Imaging Reporting and Data System (BI-RADS). A comprehensive understanding of CEM is essential for further enhancing its role in both screening and managing patients with breast malignancies. CEM can also be beneficial for problem-solving, improving the management of uncertain breast findings. Practitioners in this field should become more cognizant of how and when to employ this technique and interpret the various CEM findings. This paper aims to outline the key findings in the updated version of the BI-RADS specifically dedicated to CEM. Additionally, it will present some clinical cases commonly encountered in clinical practice.Critical relevance statement Standardized reporting and a thorough understanding of CEM findings are pivotal for advancing the role of CEM in screening and managing breast cancer patients. This standardization contributes significantly to integrating CEM as an essential component of daily clinical practice.Key points • A complete knowledge and understanding of the findings outlined in the new BI-RADS CEM are necessary for accurate reporting.• BI-RADS CEM supplement is intuitive and practical to use.• Standardization of the CEM findings enables more accurate patient management. Graphical Abstract

SpringerOpen

European Radiology Jun 21, 2023

Letter to the Editor: ACR BI-RADS lexicon, #silicone implants, and #breast implant illness (Eduardo Fleury)

Key takeaways from the author:
• #BIRADS lexicon seems to be outdated for cohesive-gel silicone implant evaluation
• Millions of women worldwide are silenced suffering from breast implant illness
• Should we revisit the BI-RADS lexicon classification?

Have any thoughts on the Letter to the Editor? Comment below!

ACR BI-RADS lexicon, silicone implants, and breast implant illness - European Radiology

Dear Editor, I respectfully come through this opinion letter to make some remarks regarding the BI-RADS lexicon new edition, which will come into force from the year 2023 in its sixth edition, preliminarily made available by the Society of Breast Imaging (SBI) in the form of a brochure with the title of “BI-RADS: THE NEXT […]

European Radiology

Insights Into Imaging May 31, 2023

Educational Review: Mimickers of #breast #malignancy: vital to clinical pratice, playing key role in ensuring appropriate clinical management. (Mary Guirguis et al.)

#InsightsIntoImaging #breastcancer #BIRADS

Want to learn more? Click the link below ⬇️
https://insightsimaging.springeropen.com/articles/10.1186/s13244-021-00991-x

Mimickers of breast malignancy: imaging findings, pathologic concordance and clinical management - Insights into Imaging

Many benign breast entities have a clinical and imaging presentation that can mimic breast cancer. The purpose of this review is to illustrate the wide spectrum of imaging features that can be associated with benign breast diseases with an emphasis on the suspicious imaging findings associated with these benign conditions that can mimic cancer. As radiologic-pathologic correlation can be particularly challenging in these cases, the radiologist’s familiarity with these benign entities and their imaging features is essential to ensure that a benign pathology result is accepted as concordant when appropriate and that a suitable management plan is formulated.

SpringerOpen

Insights Into Imaging May 18, 2023

New #radiomics model could provide results as good as BI-RADS in classifying #mammary masses. (Kawtar Debbi et al.)

#InsightsIntoImaging #BIRADS #BreastCancer

Click here to read more ➡️ https://insightsimaging.springeropen.com/articles/10.1186/s13244-023-01404-x

Radiomics model to classify mammary masses using breast DCE-MRI compared to the BI-RADS classification performance - Insights into Imaging

Background Recent advanced in radiomics analysis could help to identify breast cancer among benign mammary masses. The aim was to create a radiomics signature using breast DCE-MRI extracted features to classify tumors and to compare the performances with the BI-RADS classification. Material and methods From September 2017 to December 2019 images, exams and records from consecutive patients with mammary masses on breast DCE-MRI and available histology from one center were retrospectively reviewed (79 patients, 97 masses). Exclusion criterion was malignant uncertainty. The tumors were split in a train-set (70%) and a test-set (30%). From 14 kinetics maps, 89 radiomics features were extracted, for a total of 1246 features per tumor. Feature selection was made using Boruta algorithm, to train a random forest algorithm on the train-set. BI-RADS classification was recorded from two radiologists. Results Seventy-seven patients were analyzed with 94 tumors, (71 malignant, 23 benign). Over 1246 features, 17 were selected from eight kinetic maps. On the test-set, the model reaches an AUC = 0.94 95 CI [0.85–1.00] and a specificity of 33% 95 CI [10–70]. There were 43/94 (46%) lesions BI-RADS4 (4a = 12/94 (13%); 4b = 9/94 (10%); and 4c = 22/94 (23%)). The BI-RADS score reached an AUC = 0.84 95 CI [0.73–0.95] and a specificity of 17% 95 CI [3–56]. There was no significant difference between the ROC curves for the model or the BI-RADS score (p = 0.19). Conclusion A radiomics signature from features extracted using breast DCE-MRI can reach an AUC of 0.94 on a test-set and could provide as good results as BI-RADS to classify mammary masses.

SpringerOpen