Interobserver agreement on the interpretation of automated whole breast ultrasonography

Kim, Eun Jeong; Kim, Sung Hun; Kang, Bong Joo; Kim, Yun Ju

doi:10.14366/usg.14015

Cited by 12 publications

(14 citation statements)

References 20 publications

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“…In accordance with this result, a recent prospective study involving 1,886 patients reported excellent overall agreement (99.8%) between HHUS and ABUS, with a kappa value of 0.994 [16]. In addition, Kim et al [21] reported good interobserver agreement of HHUS and ABUS with regard to orientation, echogenicity, margin, shape, and BI-RADS categorization. On the contrary, the interobserver agreement was significantly lower in confirmed malignancies, for which a fair kappa value was obtained.…”

Section: Discussionmentioning

confidence: 56%

Reliability of automated versus handheld breast ultrasound examinations of suspicious breast masses

et al. 2019

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Purpose The purpose of this study was to assess the reliability of automated breast ultrasound (ABUS) examinations of suspicious breast masses in comparison to handheld breast ultrasound (HHUS) with regard to Breast Imaging Reporting and Data System (BI-RADS) category assessment, and to investigate the factors affecting discrepancies in categorization. Methods A total of 135 masses that were assessed as BI-RADS categories 4 and 5 on ABUS that underwent ultrasound (US)-guided core needle biopsy from May 2017 to December 2017 were included in this study. The BI-RADS categories were re-assessed using HHUS. Agreement of the BI-RADS categories was evaluated using kappa statistics, and the positive predictive value of each examination was calculated. Logistic regression analysis was performed to identify the mammography and US findings associated with discrepancies in the BI-RADS categorization. Results The overall agreement between ABUS and HHUS in all cases was good (79.3%, kappa=0.61, P<0.001). Logistic regression analysis revealed that accompanying suspicious microcalcifications on mammography (odds ratio [OR], 4.63; 95% confidence interval [CI], 1.83 to 11.71; P=0.001) and an irregular shape on US (OR, 5.59; 95% CI, 1.43 to 21.83; P=0.013) were associated with discrepancies in the BI-RADS categorization. Conclusion The agreement between ABUS and HHUS examinations in the BI-RADS categorization of suspicious breast masses was good. The presence of suspicious microcalcifications on mammography and an irregular shape on US were factors associated with ABUS yielding a lower level of suspicion than HHUS in terms of the BI-RADS category assessment.

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Section: Discussionmentioning

confidence: 56%

Reliability of automated versus handheld breast ultrasound examinations of suspicious breast masses

et al. 2019

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“…In a reader study, ABS significantly increased detection of breast cancer with insignificant increase in false-positive rate [71]. A few studies comparing ABS and HHUS have shown similar lesion visualization and assessments [72,73]. Barriers to ABS implementation include the several thousand images to be reviewed with average 6-minute interpretation time [54] and learning curve in dismissing artifactual posterior shadowing at the interface of fat lobules [54,57,68].…”

Section: Screening Ultrasoundmentioning

confidence: 99%

Breast density implications and supplemental screening

2018

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Digital breast tomosynthesis (DBT) has been widely implemented in place of 2D mammography, although it is less effective in women with extremely dense breasts. Breast ultrasound detects additional early-stage, invasive breast cancers when combined with mammography; however, its relevant limitations, including the shortage of trained operators, operator dependence and small field of view, have limited its widespread implementation. Automated breast sonography (ABS) is a promising technique but the time to interpret and false positive rates need to be improved. Supplemental screening with contrast-enhanced magnetic resonance imaging (MRI) in high-risk women reduces late-stage disease; abbreviated MRI protocols may reduce cost and increase accessibility to women of average risk with dense breasts. Contrast-enhanced digital mammography (CEDM) and molecular breast imaging improve cancer detection but require further validation for screening and direct biopsy guidance should be implemented for any screening modality. This article reviews the status of screening women with dense breasts.

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“…In general, interpretation of AB US images using the Breast Imaging Reporting and Data System (BI-RADS) US lexicon (34,35) is sufficient for screening and diagnostic purposes. Using the BI-RADS lexicon for AB US appears to provide higher agreement between radiologists than using it for handheld US (36). The coronal and sagittal refor-matted images contain additional information that can aid in differentiation of breast lesions (33,37).…”

Section: Postprocessing Multiplanar Reformation and Image Interpretmentioning

confidence: 99%

Automated Three-dimensional Breast US for Screening: Technique, Artifacts, and Lesion Characterization

Zelst¹,

Mann²

2018

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Automated breast (AB) ultrasonography (US) scanners have recently been brought to market for breast imaging. AB US devices use mechanically driven wide linear-array transducers that can image whole-breast US volumes in three dimensions. AB US is proposed for screening as a supplemental modality to mammography in women with dense breasts and overcomes important limitations of whole-breast US using handheld devices, such as operator dependence and limited reproducibility. A literature review of supplemental whole-breast US for screening was performed, which showed that both AB US and handheld US allow detection of mammographically negative early-stage invasive breast cancers but also increase the false-positive recall rate. Technicians with limited training can perform AB US; nevertheless, there is a learning curve for acquiring optimal images. Proper acquisition technique may allow avoidance of common artifacts that could impair interpretation of AB US results. Regardless, interpretation of AB US results can be challenging. This article reviews the US appearance of common benign and malignant lesions and presents examples of false-positive and false-negative AB US results. In situ breast cancers are rarely detected with supplemental whole-breast US. The most discriminating feature that separates AB US from handheld US is the retraction phenomenon on coronal reformatted images. The retraction phenomenon is rarely seen with benign findings but accompanies almost all breast cancers. In conclusion, women with dense breasts may benefit from supplemental AB US examinations. Understanding the pitfalls in acquisition technique and lesion interpretation, both of which can lead to false-positive recalls, might reduce the potential harm of performing supplemental AB US. Online supplemental material is available for this article. RSNA, 2018.

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Interobserver agreement on the interpretation of automated whole breast ultrasonography

Cited by 12 publications

References 20 publications

Reliability of automated versus handheld breast ultrasound examinations of suspicious breast masses

Reliability of automated versus handheld breast ultrasound examinations of suspicious breast masses

Breast density implications and supplemental screening

Automated Three-dimensional Breast US for Screening: Technique, Artifacts, and Lesion Characterization

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