ArticleEuropean radiology2025
Inter-reader agreement of the BI-RADS CEM lexicon.
Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 18F-FDG PET/CT Semiquantitative and Radiomic Features for Assessing Pathologic Axillary Lymph Node Status in Clinical Stage I-III Breast Cancer Patients: A Systematic Review.Current oncology (Toronto, Ont.) · 2025Pooled it
- How Does ACR BI-RADSDiagnostics (Basel, Switzerland) · 2026Review
- Contrast-Enhanced Mammography in Breast Cancer Follow-Up: Diagnostic Value in Suspected Recurrence.Journal of imaging · 2025Article
- Why clinical context and sustainability matters: the role of high-concentration contrast in CEM.Insights into imaging · 2025Article
- An Updated Systematic Review and Meta-Analysis of Diagnostic Accuracy of Dynamic Contrast Enhancement and Diffusion-Weighted MRI in Differentiating Benign and Malignant Non-Mass Enhancement Lesions.Journal of clinical medicine · 2025Review
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Abstract
purposeThe purpose of this study was to assess the inter-reader agreement of the breast imaging reporting and data system (BI-RADS) contrast-enhanced mammography (CEM) lexicon. MATERIALS AND
methodsIn this IRB-approved, single-center, retrospective study, three breast radiologists, each with different levels of experience, reviewed 462 lesions in 421 routine clinical CEM according to the fifth edition of the BI-RADS lexicon for mammography and to the first version of the BI-RADS lexicon for CEM. Readers were blinded to patient outcomes and evaluated breast and lesion features on low-energy (LE) images (breast density, type of lesion, associated architectural distortion), lesion features on recombined (RC) images (type of enhancement, characteristic of mass enhancement, non-mass enhancement or enhancing asymmetry), and provided a final BI-RADS assessment. The inter-reader agreement was calculated for each evaluated feature using Fleiss' kappa coefficient. Sensitivity and specificity were calculated.
resultsThe inter-reader agreement was moderate to substantial for breast density (ĸ = 0.569), type of lesion on LE images (ĸ = 0.654), and type of enhancement (ĸ = 0.664). There was a moderate to substantial agreement on CEM mass enhancement descriptors. The agreement was fair to moderate for non-mass enhancement and enhancing asymmetry descriptors. Inter-reader agreement for LE and LE with RC BI-RADS assessment was moderate (ĸ = 0.421) and fair (ĸ = 0.364). Diagnostic performance was good and comparable for all readers.
conclusionInter-reader agreement of the CEM lexicon was moderate to substantial for most features. There was a low agreement for some RC descriptors, such as non-mass enhancement and enhancing asymmetry, and BI-RADS assessment, but this did not impact the diagnostic performance. KEY POINTS: Question Data on the reproducibility and inter-reader agreement for the first version of the BI-RADS lexicon dedicated to CEM are missing. Finding The inter-reader agreement for the lexicon was overall substantial to moderate, but it was lower for the descriptors for non-mass enhancement and enhancing asymmetry. Clinical relevance A common lexicon simplifies communication between specialists in clinical practice. The good inter-reader agreement confirms the effectiveness of the CEM-BIRADS in ensuring consistent communication. Detailed definitions of some descriptors (non-mass, enhancing asymmetry) are needed to ensure higher agreements.
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