title: Inter- and Intra-Observer Agreement in Ultrasound BI-RADS Classification and Real-Time Elastography Tsukuba Score Assessment of Breast Lesions.
abstract: Our aim was to prospectively evaluate inter- and intra-observer agreement between Breast Imaging Reporting and Data System (BI-RADS) classifications and Tsukuba elasticity scores (TSs) of breast lesions. The study included 164 breast lesions (63 malignant, 101 benign). The BI-RADS classification and TS of each breast lesion was assessed by the examiner and twice by three reviewers at an interval of 2 months. Weighted κ values for inter-observer agreement ranged from moderate to substantial for BI-RADS classification (κ = 0.585-0.738) and was substantial for TS (κ = 0.608-0.779). Intra-observer agreement was almost perfect for ultrasound (US) BI-RADS (κ = 0.847-0.872) and TS (κ = 0.879-0.914). Overall, individual reviewers are highly self-consistent (almost perfect intra-observer agreement) with respect to BI-RADS classification and TS, whereas inter-observer agreement was moderate to substantial. Comprehensive training is essential for achieving high agreement and minimizing the impact of subjectivity. Our results indicate that breast US and real-time elastography can achieve high diagnostic performance.
authors: Department of Gynecology and Obstetrics, University Hospital of Basel, Basel, Switzerland.
authors: Fabienne
authors: F
authors: Schwab
authors: Department of Gynecology and Obstetrics, University Hospital of Basel, Basel, Switzerland.
authors: Katharina
authors: K
authors: Redling
authors: Department of Gynecology and Obstetrics, University Hospital of Basel, Basel, Switzerland.
authors: Matthias
authors: M
authors: Siebert
authors: Statistics, Department of Gynecology and Obstetrics, University Hospital of Basel, Basel, Switzerland.
authors: Andy
authors: A
authors: Schötzau
authors: Department of Chemistry, University of Basel, Basel, Switzerland.
authors: Cora-Ann
authors: CA
authors: Schoenenberger
authors: Department of Gynecology and Obstetrics, University Hospital of Basel, Basel, Switzerland. Electronic address: rosanna.zanetti@usb.ch.
authors: Rosanna
authors: R
authors: Zanetti-Dällenbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D011873:Radiology Information Systems / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
keywords: BI-RADS; Breast Imaging Reporting and Data System; Breast elastography; Breast ultrasound; Inter-observer agreement; Intra-observer agreement; Tsukuba score