Related Experiment Video
Updated: May 1, 2026
Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Interpretation of automated breast ultrasound (ABUS) with and without knowledge of mammography: a reader performance
Per Skaane1, Randi Gullien2, Ellen B Eben2
1Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Norway PERSKA@ous-hf.no.
Background:
Automated breast ultrasonography (ABUS) has the potential to be an important adjunct to mammography in women with dense breasts.
Purpose:
To compare reader performance and inter-observer variation of ABUS alone and in combination with mammography.
Material And Methods:
This retrospective study had ethical committee approval. All women gave written informed consent. One hundred and fourteen breasts in 90 women examined by digital mammography and ABUS were interpreted by five radiologists using BI-RADS categories. The 114 breasts included 38 cancers and 76 normal or benign findings. In the first reading session ABUS only was interpreted, and in the second ABUS plus digital mammography. Image interpretations were done without knowledge of clinical or imaging results. A consensus panel analyzed false negative and false positive interpretations. Reading time was recorded for one radiologist. AUC was used for performance measurement, and kappa statistic for inter-observer variability.
Results:
Mean size for cancers was 16.2 mm; area under the curve (AUC) values for ABUS alone and for combined reading were, respectively: reader A, 0.592-0.744; reader B, 0.740-0.947; reader, C 0.759-0.823; reader D, 0.670-0.688; reader E, 0.904-0.923; and all readers combined 0.730-0.823. The higher AUC for combined reading was statistically significant (P < 0.05) for reader B and for all readers. There was a considerable inter-observer variability. Observer agreement revealed following kappa values for ABUS alone and combined reading, respectively: reader A, 0.22-0.30; reader B, 0.33-0.44; reader C, 0.32-0.39; reader D, 0.07-0.14; and reader E, 0.34-0.43. Shadowing from dense parenchyma was the most common cause of false positive ABUS interpretations. Mean interpretation time for a bilateral normal ABUS examination was 9 min.
Conclusion:
Observer agreement was higher and all radiologists improved diagnostic performance using combined ABUS and mammography interpretation. Combined reading should be standard if ABUS is implemented in screening of women with dense breasts.
Related Concept Videos
01:20Ultrasound I: Abdominal Ultrasonography
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called...
01:24Imaging Studies II: Ultrasonography