Inter- and Intra-observer Agreement of BI-RADS-based Subjective Visual Estimation of Amount of Fibroglandular Breast Tissue with Magnetic Resonance Imaging: Comparison to Automated Quantitative Assessment

Overview

Journal Eur Radiol

Specialty Radiology

Date 2016 Apr 25

PMID 27108300

Citations 13

Authors

G J Wengert

T H Helbich

R Woitek

P Kapetas

P Clauser

P A Baltzer

W-D Vogl

M Weber

A Meyer-Baese

Katja Pinker

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the inter-/intra-observer agreement of BI-RADS-based subjective visual estimation of the amount of fibroglandular tissue (FGT) with magnetic resonance imaging (MRI), and to investigate whether FGT assessment benefits from an automated, observer-independent, quantitative MRI measurement by comparing both approaches.

Materials And Methods: Eighty women with no imaging abnormalities (BI-RADS 1 and 2) were included in this institutional review board (IRB)-approved prospective study. All women underwent un-enhanced breast MRI. Four radiologists independently assessed FGT with MRI by subjective visual estimation according to BI-RADS. Automated observer-independent quantitative measurement of FGT with MRI was performed using a previously described measurement system. Inter-/intra-observer agreements of qualitative and quantitative FGT measurements were assessed using Cohen's kappa (k).

Results: Inexperienced readers achieved moderate inter-/intra-observer agreement and experienced readers a substantial inter- and perfect intra-observer agreement for subjective visual estimation of FGT. Practice and experience reduced observer-dependency. Automated observer-independent quantitative measurement of FGT was successfully performed and revealed only fair to moderate agreement (k = 0.209-0.497) with subjective visual estimations of FGT.

Conclusion: Subjective visual estimation of FGT with MRI shows moderate intra-/inter-observer agreement, which can be improved by practice and experience. Automated observer-independent quantitative measurements of FGT are necessary to allow a standardized risk evaluation.

Key Points: • Subjective FGT estimation with MRI shows moderate intra-/inter-observer agreement in inexperienced readers. • Inter-observer agreement can be improved by practice and experience. • Automated observer-independent quantitative measurements can provide reliable and standardized assessment of FGT with MRI.

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