Breast MRI: does a clinical decision algorithm outweigh reader experience?
Poetsch N, Korajac A, Stelzer P, Kapetas P, Milos RI, Dietzel M, Helbich TH, Clauser P, Baltzer PAT (2022)
Publication Type: Journal article
Publication year: 2022
Journal
DOI: 10.1007/s00330-022-09015-8
Abstract
Objectives Due to its high sensitivity, DCE MRI of the breast (MRIb) is increasingly used for both screening and assessment purposes. The Kaiser score (KS) is a clinical decision algorithm, which formalizes and guides diagnosis in breast MRI and is expected to compensate for lesser reader experience. The aim was to evaluate the diagnostic performance of untrained residents using the KS compared to off-site radiologists experienced in breast imaging using only MR BI-RADS. Methods Three off-site, board-certified radiologists, experienced in breast imaging, interpreted MRIb according to the MR BI-RADS scale. The same studies were read by three residents in radiology without prior training in breast imaging using the KS. All readers were blinded to clinical information. Histology was used as the gold standard. Statistical analysis was conducted by comparing the AUC of the ROC curves. Results A total of 80 women (median age 52 years) with 93 lesions (32 benign, 61 malignant) were included. The individual within-group performance of the three expert readers (AUC 0.723-0.742) as well as the three residents was equal (AUC 0.842-0.928), p > 0.05, respectively. But, the rating of each resident using the KS significantly outperformed the experts' ratings using the MR BI-RADS scale (p <= 0.05). Conclusion The KS helped residents to achieve better results in reaching correct diagnoses than experienced radiologists empirically assigning MR BI-RADS categories in a clinical "problem solving MRI" setting. These results support that reporting breast MRI benefits more from using a diagnostic algorithm rather than expert experience.
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Austria (AT)How to cite
APA:
Poetsch, N., Korajac, A., Stelzer, P., Kapetas, P., Milos, R.-I., Dietzel, M.,... Baltzer, P.A.T. (2022). Breast MRI: does a clinical decision algorithm outweigh reader experience? European Radiology. https://dx.doi.org/10.1007/s00330-022-09015-8
MLA:
Poetsch, Nina, et al. "Breast MRI: does a clinical decision algorithm outweigh reader experience?" European Radiology (2022).
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