Literature DB >> 10350302

Sonography of solid breast lesions: observer variability of lesion description and assessment.

J A Baker1, P J Kornguth, M S Soo, R Walsh, P Mengoni.   

Abstract

OBJECTIVE: The purpose of this study was to measure the level of inter- and intraobserver agreement and to evaluate the causes of variability in radiologists' descriptions and assessments of sonograms of solid breast masses.
MATERIALS AND METHODS: Sixty sonograms of solid masses were evaluated independently by five radiologists. Observers used the lexicon of a recently published benchmark report on sonographic appearances of breast masses to determine mass shape, margin, echogenicity, echo texture, presence of echogenic pseudocapsule, and acoustic transmission. Final diagnostic assessments were determined by applying the rule-based model of the same benchmark report to the radiologists' descriptions. In addition, one observer interpreted each case twice to evaluate intraobserver variability. Inter- and intraobserver variability were measured using Cohen's kappa statistic. We also investigated causes of variability in radiologists' descriptions.
RESULTS: Interobserver agreement ranged from lowest for determining the presence of an echogenic pseudocapsule (kappa = .09) to highest for determining mass shape (kappa = .8). Intraobserver agreement was lowest for mass echo texture (kappa = .24) and greatest for mass shape (kappa = .79). Variability in descriptions of lesions contributed to interobserver (kappa = .51) and some intraobserver (kappa = .66) inconsistency in assessing the likelihood of malignancy.
CONCLUSION: Lack of uniformity among observers' use of descriptive terms for solid breast masses resulted in inconsistent diagnoses. The need for improved definitions and additional illustrative examples could be addressed by developing a standardized lexicon similar to that of the Breast Imaging Reporting and Data System.

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Year:  1999        PMID: 10350302     DOI: 10.2214/ajr.172.6.10350302

Source DB:  PubMed          Journal:  AJR Am J Roentgenol        ISSN: 0361-803X            Impact factor:   3.959


  22 in total

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