Breast Imaging Reporting and Data System (BI-RADS)

2018 ◽  
Author(s):  
Carl D’Orsi
Keyword(s):  
Cancer Detection ◽  
Breast Imaging ◽  
False Negative ◽  
Breast Mri ◽  
Breast Ultrasound ◽  
Cancer Detection Rate ◽  
Data System ◽  
True Positive ◽  
True Negative ◽  
Predictive Values

This chapter, devoted to the Breast Imaging Reporting and Data System (BI-RADS), describes the standardized language applied to findings in mammography, breast ultrasound, and breast MRI. BI-RADS terms most frequently used are described, and most are illustrated by figures. In addition, the rules for a facility and radiologist audit are described, with definitions of true positive (TP), false positive (FP), true negative (TN), and false negative (FN) findings. Sensitivity (Se), specificity (Sp), positive predictive values 1, 2, and 3 (PPV1, 2, 3), and cancer detection rate are defined. An example of an audit is provided to clarify the use of these metrics.

The Clinically Relevant Breast Imaging Audit

2020 ◽  
Vol 2 (1) ◽  
pp. 2-6
Author(s):  
Carl Joseph D’Orsi
Keyword(s):  
Breast Imaging ◽  
False Negative ◽  
Accurate Method ◽  
Recall Rate ◽  
Basic Data ◽  
True Positive ◽  
True Negative ◽  
Data Points ◽  
Diagnosis Of Cancer ◽  
Definition Of

Abstract An audit of a breast imaging practice must be based on data with accepted definitions and rules so that the comparisons between breast imaging facilities and interpretive staff are comparable. The four basic data points for calculating these metrics are true positive (TP), true negative (TN), false positive (FP), and false negative (FN). For mammography, the definition of “true” is the presence of a proven malignancy within a year of the exam. The presence or absence of breast cancer within a year of the exam and an increase in patient mobility between different facilities may render the calculation of sensitivity and specificity difficult for most facilities unless a regional cancer registry is available.Thus, the metrics that can be easily calculated within a facility are recall rate (all the positive interpretations divided by all the exams read), positive predictive value (PPV) 1 = percentage of abnormal screening exams that result in a diagnosis of cancer within a year, PPV2 = percentage of all diagnostic exams recommended for biopsy and cancer discovered within a year, PPV3 = benign tissue diagnosis and no cancer within a year, and the cancer detection rate (the true positive exams per one thousand exams). Intuitively, one may assume that accuracy (TP + TN/TP + FP + TN + FN) is the best metric for an interpreter. However, this can produce spurious results. The most accurate method to determine a reader’s skills is the use of the receiver operating characteristic (ROC) curve, which clearly presents, in graphic form, the relationship between the four basic data points.

scholarly journals BREAST CANCER SCREENING;

2017 ◽  
Vol 24 (01) ◽  
pp. 42-46
Author(s):  
Hassan Bukhari ◽  
Asim Shaukat ◽  
Nosheen Ahmad
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Breast Cancer Screening ◽  
False Negative ◽  
Breast Mri ◽  
Breast Lesions ◽  
True Positive ◽  
True Negative

Objectives: To compare the efficacy of Magnetic resonance imaging andMammography for Breast-Cancer Screening in high risk Women with a Familial or GeneticPredisposition. Study Design: Cross-sectional study. Setting: Department of Radiology AlliedHospital, Faisalabad. Duration: From January 2012 to December 2014, Sample size: 299.Methods: A total of 299 females at high risk of breast cancer were included in this study andthey underwent screening rounds of Mammogram and contrast enhanced dynamic breastMRI once a year with independent readings. Both the imaging modalities were interpreted byexperience radiologist and all the images were categorized using Breast Imaging Reportingand Data System. In each patient, histopathology results were considered the standard criteriafor the calculation of the sensitivity, specificity for both Mammogram and Breast MRI lesions.Results: Mean age of the patients was 46.69±11.86 years. Mammography revealed 11 (3.68%)true positive breast lesions, 22 (7.36%) false positive lesion, 247 (82.61%) true negative and19 (6.35%) false negative lesions yielding the sensitivity of 36.67% and diagnostic accuracy of86.3%. Dynamic breast MRI revealed 28 (9.36%) true positive breast lesions with 5 (1.67%) falsepositive, 264 (88.29%) true negative and 2 (0.67%) false negative lesions yielding sensitivity of93.3%,specificity of 98.14%,PPV=84.85%,NPV=99.25% and diagnostic accuracy of 97.66%.MRI breast was significantly more sensitive (93.3 vs. 36.67%) and accurate (97.66 vs. 86.3%)than mammography. Conclusion: MRI is more sensitive than mammography in detectingtumors in women with an inherited susceptibility to breast cancer.

scholarly journals Comparison of Ultrasonography and Fine Needle Aspiration Cytology in the Diagnosis of Malignant Breast Lesions in a Rural Setup

2016 ◽  
Vol 02 (02) ◽  
pp. 058-065
Author(s):  
Rounak Kalwani ◽  
K Kher ◽  
Sonam Daftari
Keyword(s):  
False Negative ◽  
Needle Aspiration ◽  
True Positive ◽  
Breast Lump ◽  
Aspiration Cytology ◽  
True Negative ◽  
Predictive Values ◽  
Malignant Breast ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Abstract Introduction: Breast cancer is the most common cancer diagnosed in women worldwide. These rising trends have emphasized the need of prompt detection, effective clinical evaluation, and exact diagnosis of the breast disease. Aim: To analyze and compare the sensitivity, specificity, and predictive values and accuracy of ultrasonography (USG) and fine needle aspiration cytology (FNAC) in diagnosing malignant breast lump. Materials and methods: A cross-sectional, prospective study was done. One hundred sixteen female patients attending surgery department with breast lump were included. After complete clinical evaluation of the lump, all patients underwent USG and FNAC examination for diagnosis of the lump, and further subjected to excisional biopsy/definitive surgery, the results of which were further compared with the histopathological results to determine the accuracy, sensitivity, specificity, and predictive values of FNAC and USG. Results: Out of 116, 61 (52.58%) benign lesions were found while the remaining 55 (47.41%) resulted to be malignant lesions on histopathological examination (HPE). Ultrasonography reported 46 true positive, 60 true negative, and 4 false negative cases with 6 inconclusive reports; whereas, FNAC reported 47 true positive, 61 true negative, and 6 false negative cases with 2 inconclusive reports. There were no false positive cases detected by USG and FNAC. Thus, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for USG was found to be 92, 100, 100, 93.75, and 96.36% (χ2-value = 94.88, p-value = 0.0001,S) and values of 88.68, 100, 100, 91.04, and 94.73% were obtained for FNAC respectively (χ2-value = 92.04, p = 0.0001,S). Conclusion: In diagnosing malignant breast lesion, USG and FNAC are 100% specific. Although USG appears more sensitive than FNAC, the percentage of indeterminate report is higher with USG.

scholarly journals Coupling Uncertainties with Accuracy Assessment in Object-based Slum Detections, Case Study: Jakarta, Indonesia

2017 ◽  
Author(s):  
Jati Pratomo ◽  
Monika Kuffer ◽  
Javier Martinez ◽  
Divyani Kohli
Keyword(s):  
Land Tenure ◽  
Classification Accuracy ◽  
Accuracy Assessment ◽  
False Negative ◽  
National Policy ◽  
True Positive ◽  
True Negative ◽  
Object Based ◽  
The Impact

Object-Based Image Analysis (OBIA) has been successfully used to map slums. In general, the occurrence of uncertainties in producing geographic data is inevitable. However, most studies concentrated solely on assessing the classification accuracy and neglecting the inherent uncertainties. Our research analyses the impact of uncertainties in measuring the accuracy of OBIA-based slum detection. We selected Jakarta as our case study area, because of a national policy of slum eradication, which is causing rapid changes in slum areas. Our research comprises of four parts: slum conceptualization, ruleset development, implementation, and accuracy and uncertainty measurements. Existential and extensional uncertainty arise when producing reference data. The comparison of a manual expert delineations of slums with OBIA slum classification results into four combinations: True Positive, False Positive, True Negative and False Negative. However, the higher the True Positive (which lead to a better accuracy), the lower the certainty of the results. This demonstrates the impact of extensional uncertainties. Our study also demonstrates the role of non-observable indicators (i.e., land tenure), to assist slum detection, particularly in areas where uncertainties exist. In conclusion, uncertainties are increasing when aiming to achieve a higher classification accuracy by matching manual delineation and OBIA classification.

scholarly journals Comparison Study Between Local TSH IRMA Kit (CRRT) and Imported TSH IRMA Kit (Riakey, Korea)

2019 ◽  
Vol 4 (2) ◽  
pp. 77
Author(s):  
Gina Mondrida ◽  
Triningsih Triningsih ◽  
Kristina Dwi Purwanti ◽  
Sutari Sutari ◽  
Sri Setyowati ◽  
...  
Keyword(s):  
False Negative ◽  
Thyroid Stimulating Hormone ◽  
The Body ◽  
True Positive ◽  
Comparison Study ◽  
Complex Matrix ◽  
Normal Range ◽  
True Negative ◽  
Immunoassay Technique ◽  
Tsh Levels

<p><em>Thyroid Stimulating Hormone</em> (TSH) is one of hormones that our body need for growth of brains, bones and other tissues and regulate the metabolism in the body. Normal range of TSH for adult is from 0.3 to 5.5 µIU/ml, whereas for baby ranged from 3 to 18 µIU/ml. An Immunoradiometricassay (IRMA) is one of immunoassay technique using radionuclide as the tracer to detect low quantity of analyte. This technique is suitable for determine TSH levels in human blood serum which has complex matrix and various concentration. The Center for Radioisotope and Radiopharmaceutical Technology (CRRT)-BATAN has developed a reagent of TSH IRMA kit. The aim of this research is to compare between local TSH IRMA kit (CRRT-BATAN) and imported TSH IRMA kit (Riakey, Korea) toward 110 adult samples obtained from PTKMR - BATAN. The results showed 97 samples as true negative, 5 samples as true positive, 1 sample as false negative and 7 samples false positive. The comparison study gave diagnostic sensitivity as much as 83.33 %, diagnostic spesificity as much as 93.27 % and accuracy as much as 92.72 %.</p>

scholarly journals Discordance between fine-needle aspiration cytology and histopathology in patients with mucoepidermoid carcinoma of parotid gland

2020 ◽  
Vol 102 (5) ◽  
pp. 340-342
Author(s):  
H Iftikhar ◽  
M Sohail Awan ◽  
M Usman ◽  
A Khoja ◽  
W Khan
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Mucoepidermoid Carcinoma ◽  
False Negative ◽  
Needle Aspiration ◽  
True Positive ◽  
Aspiration Cytology ◽  
True Negative ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Introduction Fine-needle aspiration cytology (FNAC) is an important diagnostic tool used preoperatively for the diagnosis of parotid lump. Mucoepidermoid carcinoma comprises 5–10% of all salivary gland tumours. It poses a diagnostic challenge on FNAC with high false negative rate. The objective of this study was to evaluate the discordance between cytology/FNAC and histopathology in patients with mucoepidermoid carcinoma. Material and methods A cross-sectional study was conducted from 1 January 2010 to 31 December 2014. Patients aged 18 years and above with FNAC or histopathology suggestive of mucoepidermoid carcinoma were identified. FNAC when compared with histology (gold standard) was classified into true positive (presence of mucoepidermoid carcinoma correctly diagnosed on FNAC), true negative (absence of mucoepidermoid carcinoma correctly diagnosed on FNAC), false positive (FNAC incorrectly diagnosed mucoepidermoid carcinoma), false negative (FNAC failed to diagnose mucoepidermoid carcinoma). Results A total of 16 patients fulfilled our eligibility criteria. Seven cytological samples were true positive (ie correctly diagnosed mucoepidermoid carcinoma by FNAC), eight cytological specimens were false negative (ie could not pick up mucoepidermoid carcinoma on FNAC). One case was false positive on cytology (ie diagnosed mucoepidermoid carcinoma on FNAC but was reported to be Warthin’s tumour on histopathology) and none were true negative. Conclusion FNAC is not reliable for diagnosis of mucoepidermoid carcinoma. More than 50% of our patients had discordant results between cytology and histology. We recommend a high index of suspicion for mucoepidermoid carcinoma given the poor yield of cytology.

Serum Levels of Carcinoembryonic Antigen, Gastrointestinal Cancer-Associated Antigen and Alphafetoprotein in Staging and Management of Patients with Advanced Carcinoma of the Stomach

1987 ◽  
Vol 2 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Janusz J. Szymendera ◽  
Andrzej W. Szawlowski ◽  
Marek P. Nowacki ◽  
Malgorzata Kowalska ◽  
Janina A. Kaminska ◽  
...  
Keyword(s):  
Carcinoembryonic Antigen ◽  
Gastrointestinal Cancer ◽  
False Negative ◽  
Serum Levels ◽  
True Positive ◽  
True Negative ◽  
Carcinoma Of The Stomach ◽  
Joint Application ◽  
Serum Cea

Serum levels of carcinoembryonic antigen (CEA), gastrointestinal cancer-associated antigen (GICA or CA 19-9), and alphafetoprotein (AFP) were concurrently determined in patients with carcinoma of the stomach: in 84 preoperatively, and in 67 serially postoperatively. Before surgery, serum CEA gave information about the tumor load analogous to serum GICA in 69% of the patients: true-positive in 25% and false-negative in 43%; less information in 18% and more in 14%. The sensitivity of the test tended to be better in the more advanced stages, and was higher for CEA with GICA than for CEA alone or GICA alone. During follow-up, serum CEA gave information about the presence or absence of active disease analogous to serum GIC A in 78% of the patients: true-positive in 30%, true-negative in 36% and false-negative in 12%; less information in 9% and more in 13%. Neither test gave any false-positive indications. Sensitivity of the test rose from 67% for CEA alone and 60% for GICA alone to 81% for CEA with GICA. Serum AFP was elevated only preoperatively in 2% of patients. We conclude that joint application of CEA and GICA tests gave only slightly better preoperative sensitivity than CEA alone or GICA alone but proved fairly sensitive for postoperative follow-up of the patients. AFP was of little value for either purpose.

Mammographic findings of women recalled for diagnostic work-up in digital versus screen-film mammography in a population-based screening program

2010 ◽  
Vol 51 (5) ◽  
pp. 491-497 ◽  
Author(s):  
Seppo Lipasti ◽  
Ahti Anttila ◽  
Martti Pamilo
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Population Based ◽  
Cancer Detection Rate ◽  
Common Finding ◽  
Radiological Findings ◽  
Predictive Values ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Background: Limited information is available concerning differences in the radiological findings of women recalled for diagnostic work-up in digital mammography (DM) versus screen-film mammography (SFM) screening. Purpose: To compare the radiological findings, their positive predictive values (PPVs) for cancer and other process indicators of DM screening performed by computed radiography (CR) technology and SFM screening in a population-based program. Material and Methods: The material consisted of women, 50–59 years of age, who were invited for screening: 30 153 women with DM in 2007–2008 and 32 939 women with SFM in 1999–2000. The attendance rate was 77.7% (23 440) in the DM arm and 83.8% (27 593) in the SFM arm. In the DM arm, 1.71% of those screened (401) and in the SFM arm 1.59% (438) were recalled for further work-up. The images resulting in the recall were classified as: 1) tumor-like mass, 2) parenchymal distortion/asymmetry, 3) calcifications, and 4) combination of mass and calcifications. The distributions of the various radiological findings and their PPVs for cancer were compared in both study groups. The recall rates, cancer detection rates, test specificities, and PPVs of the DM and SFM groups were also compared. Results: Women were recalled for diagnostic work-up most often due to tumor-like mass. It was more common in SFM (1.08% per woman screened) than in DM (0.93%). The second most common finding was parenchymal distortion and asymmetry, more often in DM (0.58%) than in SFM (0.37%). Calcifications were the third most common finding. DM exposed calcifications more often (0.49%) than SFM (0.26%). The PPVs for cancer of the recalls were higher in DM than in SFM in all subgroups of radiological findings. The test specificities were similar (DM 98.9%, SFM 98.8%). Significantly more cancers were detected by DM (cancer detection rate 0.623% per woman screened, n=146) than by SFM (cancer detection rate 0.406% per woman screened, n=112). The PPVs for cancer of all recalls for diagnostic work-up were significantly higher in DM (36%) than in SFM (26%). Conclusion: In DM women were recalled for diagnostic work-up more often for calcifications, parenchymal distortions, and asymmetries than in SFM. In the case of tumor-like masses, more women were recalled in SFM. DM detected more cancers than SFM, and the PPVs for cancer were higher in DM than in SFM in all subgroups of radiological findings.

Digital mammography in a screening programme and its implications for pathology: a comparative study

2010 ◽  
Vol 64 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Linda Feeley ◽  
Donal Kiernan ◽  
Therese Mooney ◽  
Fidelma Flanagan ◽  
Gormlaith Hargaden ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Digital Mammography ◽  
Detection Rate ◽  
Screening Programme ◽  
Ductal Carcinoma ◽  
Recall Rate ◽  
Primary Objective ◽  
Cancer Detection Rate ◽  
Detection Rates ◽  
Predictive Values

AimsMost studies comparing full-field digital mammography (FFDM) with conventional screen-film mammography (SFM) have been radiology-based. The pathological implications of FFDM have received little attention in the literature, especially in the context of screening programmes. The primary objective of this retrospective study is to compare FFDM with SFM in a population-based screening programme with regard to a number of pathological parameters.MethodsDuring the study period, 107 818 women underwent screening mammograms with almost equal numbers obtained with each technique (49.9% with SFM vs 50.1% with FFDM). We compared SFM with FFDM using the following parameters: recall rate, diagnostic core biopsy rate, cancer detection rates, B3 rate, B4 rate, preoperative diagnostic rate for malignancy, positive predictive values and tumour characteristics.ResultsThe recall rate was significantly higher with FFDM (4.21% vs 3.52%, p<0.0001). The overall cancer detection rate of 7.2 per 1000 women screened with FFDM was also significantly higher than the rate of 6.2 per 1000 women screened with SFM (p=0.04). The B3 rate in the SFM group was 1.3 per 1000 women screened versus 2.5 per 1000 women screened in the FFDM group (p<0.001). The recall rate and cancer detection rates (overall, invasive and pure ductal carcinoma in situ) were all significantly higher with FFDM for lesions presenting as microcalcifications.ConclusionsThe higher cancer detection rate with FFDM in this study was due to improved detection of microcalcifications. However, this was achieved at the cost of a higher recall rate and a higher B3 rate, indicating that overtreatment may be problematic with digital mammography.

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