title: Does formal instruction about the BI-RADS ultrasound lexicon result in improved appropriate use of the lexicon?
abstract: OBJECTIVE
  The purpose of this article is to determine whether formal instruction regarding the BI-RADS ultrasound lexicon results in improved appropriate use of the lexicon.
  
  
  METHODS
  Ninety test questions depicting the features outlined by the 2003 BI-RADS lexicon were identified in our PACS. Informed consent was obtained from 34 radiology residents. The participants took the preinstruction test and then had 1 hour of formal instruction regarding the BI-RADS ultrasound lexicon, which included images depicting the different sonographic features and final assessment (including subcategories 4a, 4b, and 4c). The participants then completed the postinstruction test, which examined the same content. Test scores were calculated for both the pre- and postinstruction tests and then were compared by a linear mixed model and Wilcoxon signed rank tests.
  
  
  RESULTS
  The participants' postinstruction test scores showed significant improvement in the overall use of the BI-RADS ultrasound lexicon (p < 0.0001). There was also significant improvement in the following specific areas: final assessment (p = 0.0005), margin (p = 0.0003), orientation (p = 0.0104), and lesion boundary (p = 0.0050). The categories for which test scores did not show significant improvement were echo pattern (p = 0.07), posterior acoustic features (p = 0.50), shape (p = 0.98), and subset of the final assessment (p = 0.24).
  
  
  CONCLUSIONS
  Formal instruction regarding the BI-RADS ultrasound lexicon results in improved lesion characterization and final assessment.
authors.affiliation: Department of Radiology, Baylor College of Medicine, One Baylor Plaza, MS 360, Houston, TX 77030, USA. toperez@bcm.edu
authors.forename: Tamara
authors.initials: T
authors.lastname: Ortiz-Perez
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Trevino
authors.forename: Karla A
authors.initials: KA
authors.lastname: Sepulveda
authors.forename: Susan G
authors.initials: SG
authors.lastname: Hilsenbeck
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Emily L
authors.initials: EL
authors.lastname: Sedgwick
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D016014:Linear Models; D011873:Radiology Information Systems; D018709:Statistics, Nonparametric; D016217:Ultrasonography, Mammary