Meme Mikrokalsifikasyonlarının Bı-Rads (Breast Imaging Reporting and Data System) Kriterlerine Göre Değerlendirilmesi ve Yorumcular Arası Uyumun Araştırılması

Abstract

EVALUATION OF BREAST MICROCALCIFICATIONS ACCORDING TO BI-RADS CRITERIA AND ASSESSMENT OF THE INTEROBSERVER AGREEMENT PURPOSE: Our purpose was to evaluate the positive predictive value for analysis of breast microcalcifications according to BI-RADS criteria in determination of malignancy and to assess the interobserver agreement using these criteria. MATERIALS AND METHODS: Eighty two patients with microcalcifications in their mammograms underwent surgical excision after needle localization in our institution. Mammograms of these patients were evaluated by 3 radiologists retrospectively and independently. Each observer noted the morphology, distribution and final assessment category of microcalcifications according to BI RADS criteria. By using these data and histologic findings, positive predictive values for each radiologist and the interobserver agreement were calculated. RESULTS: In the evaluation of microcalcifications according to BI-RADS criteria, positive predictive values ranged between 7-25% for category 4 lesions and 44-68% for category 5 lesions, and the interobserver agreement was fair (k: 0.12-0.31) in morphology, fair to moderate (k: 0.29-0.51) in distribution of microcalcifications, and fair (k: 0.27-0.33) in final assessment categories. Interobserver agreement was higher in assesment of milk of calcium (k: 0.26-0.43) and round microcalcifications (k: 0.32-0.66) than other typically benign microcalcifications and in fine linear or fine linear branching microcalcifications (k: 0.31-0.34) than other probably malign microcalcifications. CONCLUSION: The BI-RADS lexicon succeeded fair to moderate in reducing the ambiguity in both the description and assessment of breast lesions in our study. Such efforts will guide us to improve the accuracy in reporting mammographies, diagnosing breast cancer at the earliest stage, and to avoid unnecessary biopsies of benign lesions