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European Radiology
Published in: European Radiology 11/2016

Open Access 01-11-2016 | Breast

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

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

Published in: European Radiology | Issue 11/2016

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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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Metadata
Title
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
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
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4274-x

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