Interreader variability and predictive value of US descriptions of solid breast masses: pilot study.

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Solid breast lesions require accurate characterization to guide management.
• Ultrasound (US) is a primary imaging modality for breast lesion evaluation.
• Standardized interpretation of US characteristics can improve diagnostic accuracy.

Purpose of the Study:

• To evaluate the specificity of specific ultrasound (US) characteristics for solid breast lesions.
• To assess interreader variability in the interpretation of these US characteristics.
• To validate a US recommendation system for predicting histologic findings.

Main Methods:

• Prospective evaluation of 70 solid breast masses in 61 patients scheduled for biopsy.
• Three readers independently interpreted sonograms using established US characteristics.
• Specificity and positive predictive value (PPV) calculated against biopsy results.
• Interreader variability assessed, and a 5-category assessment system developed.

Main Results:

• High average specificities for key US characteristics: spiculation (97%), duct extension (95%), taller than wide (91%).
• Overall average specificity across readers was 88.5%.
• Positive predictive values (PPVs) for assessment categories II-V ranged from 5% to 94%.
• Readers demonstrated similar interpretations with good correlation.

Conclusions:

• The proposed US recommendation system accurately predicts histologic findings of solid breast lesions.
• A standardized sonographic classification lexicon enhances diagnostic accuracy and clinical decision-making.
• High specificity and interreader agreement support the utility of US characteristics in breast lesion assessment.