Author/Authors :
Warren، نويسنده , , Ruth A. Hayes، نويسنده , , Carmel and Pointon، نويسنده , , Linda and Hoff، نويسنده , , Rebecca and Gilbert، نويسنده , , Fiona J. and Padhani، نويسنده , , Anwar R. and Rubin، نويسنده , , Caroline and Kaplan، نويسنده , , Glenda and Raza، نويسنده , , Kauza and Wilkinson، نويسنده , , Laura and Hall-Craggs، نويسنده , , Margaret and Kessar، نويسنده , , Preminda and Rankin، نويسنده , , Sheila and Dixon، نويسنده , , Adrian K. and Walsh، نويسنده , , James and Turnbull، نويسنده , , Lindsay and Britton، نويسنده , , Peter and Sinnatamby، نويسنده , , Ruchi and Easton، نويسنده , , Doug and Thompson، نويسنده , , Deborah and Lakhani، نويسنده , , Sunil R. and Leach، نويسنده , , Martin O.، نويسنده ,
Abstract :
Objectives
m of this study was to assess the consistency and performance of radiologists interpreting breast magnetic resonance imaging (MRI) examinations.
als and Methods
st sets of eight cases comprising cancers, benign disease, technical problems and parenchymal enhancement were prepared from two manufacturersʹ equipment (X and Y) and reported by 15 radiologists using the recording form and scoring system of the UK MRI breast screening study [(MAgnetic Resonance Imaging in Breast Screening (MARIBS)]. Variations in assessments of morphology, kinetic scores and diagnosis were measured by assessing intraobserver and interobserver variability and agreement. The sensitivity and specificity of reporting performances was determined using receiver operating characteristic (ROC) curve analysis.
s
bserver variation was seen in 13 (27.7%) of 47 of the radiologistsʹ conclusions (four technical and seven pathological differences). Substantial interobserver variation was observed in the scores recorded for morphology, pattern of enhancement, quantification of enhancement and washout pattern. The overall sensitivity of breast MRI was high [88.6%, 95% confidence interval (CI) 77.4–94.7%], combined with a specificity of 69.2% (95% CI 60.5–76.7%). The sensitivities were similar for the two test sets (P=.3), but the specificity was significantly higher for the Manufacturer X dataset (P<.001). ROC curve analysis gave an area under the curve of 0.85 (95% CI 0.79–0.92)
sions
ntial variation in all elements of the scoring system and in the overall diagnostic conclusions was observed between radiologists participating in MARIBS. High overall sensitivity was achieved with moderate specificity. Manufacturer-related differences in specificities possibly occurred because the numerical thresholds set for the scoring system were not optimised for both equipment manufacturers. Scoring systems developed on one equipment software may not be transferable to other manufacturers.
