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 Journal Article


Authors: Wengert, G. J.; Helbich, T. H.; Woitek, R.; Kapetas, P.; Clauser, P.; Baltzer, P. A.; Vogl, W. D.; Weber, M.; Meyer-Baese, A.; Pinker, K.
Article 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
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. © 2016, The Author(s).
Keywords: major clinical study; comparative study; nuclear magnetic resonance imaging; magnetic resonance imaging; prospective study; image analysis; echomammography; automation; radiologist; breast imaging; mammography; quantitative analysis; breast examination; nuclear magnetic resonance scanner; breast density; human; female; priority journal; article; amount of fibroglandular tissue; inter-/intra-observer agreement; quantitative assessment of breast density; gland tissue; subjective visual estimation
Journal Title: European Radiology
Volume: 26
Issue: 11
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2016-11-01
Start Page: 3917
End Page: 3922
Language: English
DOI: 10.1007/s00330-016-4274-x
PROVIDER: scopus
PMCID: PMC5052327
PUBMED: 27108300
DOI/URL:
Notes: Article -- Export Date: 1 November 2016 -- Source: Scopus
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