title: Validation of the fifth edition BI-RADS ultrasound lexicon with comparison of fourth and fifth edition diagnostic performance using video clips.
abstract: OBJECTIVE
  The aim of this study was to evaluate the positive predictive value (PPV) and the diagnostic performance of the ultrasonographic descriptors in the fifth edition of BI-RADS, comparing with the fourth edition using video clips.
  
  
  METHODS
  From September 2013 to July 2014, 80 breast masses in 74 women (mean age, 47.5±10.7 years) from five institutions of the Korean Society of Breast Imaging were included. Two radiologists individually reviewed the static and video images and analyzed the images according to the fourth and fifth edition of BI-RADS. The PPV of each descriptor was calculated and diagnostic performances between the fourth and fifth editions were compared.
  
  
  RESULTS
  Of the 80 breast masses, 51 (63.8%) were benign and 29 (36.2%) were malignant. Suspicious ultrasonographic features such as irregular shape, non-parallel orientation, angular or spiculated margins, and combined posterior features showed higher PPV in both editions (all P<0.05). No significant differences were found in the diagnostic performances between the two editions (all P>0.05). The area under the receiver operating characteristics curve was higher in the fourth edition (0.708 to 0.690), without significance (P=0.416).
  
  
  CONCLUSIONS
  The fifth edition of the BI-RADS ultrasound lexicon showed comparable performance to the fourth edition and can be useful in the differential diagnosis of breast masses using ultrasonography.
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung Hyun
authors.identifier: 0000-0002-2100-3513
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Min Jung
authors.identifier: 0000-0003-4949-1237
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Biostastistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hye Sun
authors.identifier: 0000-0001-6328-6948
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sung Hun
authors.identifier: 0000-0003-4478-9720
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Hyun
authors.identifier: 0000-0002-7787-780X
authors.initials: JH
authors.lastname: Youk
authors.affiliation: Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Sun Hye
authors.identifier: 0000-0002-3309-0693
authors.initials: SH
authors.lastname: Jeong
authors.affiliation: Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: You Me
authors.identifier: 0000-0001-5807-9012
authors.initials: YM
authors.lastname: Kim
keywords: Biopsy; Breast Imaging Reporting and Data System (BI-RADS); Breast neoplasms; Ultrasonography