ACR BI-RADS^Ⓡ v2025: A summary of changes

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Diagnostic Medicine

Background:

• The American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) is crucial for standardized breast imaging interpretation and reporting.
• The system requires regular updates to incorporate advancements in imaging technology and clinical practice.

Purpose of the Study:

• To review and summarize the key changes in the BI-RADS v2025 Manual compared to the 5th edition.
• To highlight the integration of advanced imaging modalities and refined terminology within the new BI-RADS version.
• To discuss the implications of these updates for radiologists and clinical practice.

Main Methods:

• Comparative analysis of BI-RADS v2025 with the previous 5th edition.
• Identification and summarization of significant changes in lexicon, reporting structure, and terminology.
• Discussion of the impact of new descriptors and the omission of ambiguous terms.

Main Results:

• BI-RADS v2025 introduces year-based versioning and integrates digital breast tomosynthesis, synthetic mammography, and contrast-enhanced mammography.
• Refinements include updated descriptors for ultrasound (e.g., 'non-mass'), harmonization of lexicon across modalities, and improved mammographic density definitions.
• Ambiguous terms like 'focus' and 'developing asymmetry' have been omitted to enhance clarity.

Conclusions:

• The BI-RADS v2025 updates aim to improve consistency in terminology and reporting across different breast imaging modalities.
• These revisions support better clinical communication and outcomes monitoring in contemporary breast imaging.
• Radiologists should familiarize themselves with these changes for effective implementation in practice.