ArticlePeerJ2026
Quantitative outperforms visual assessment of nonparallel orientation in ultrasound breast imaging reporting and data system.
Article in PeerJ, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
Objective: The visual assessment of the "nonparallel orientation" descriptor in the ultrasound Breast Imaging Reporting and Data System (BI-RADS) is subjective and may affect both the accurate interpretation of breast masses and the overall diagnostic performance of the ultrasound BI-RADS. The objective of this study was to determine whether quantitative measurement of the nonparallel orientation descriptor improves diagnostic performance in the evaluation of breast malignancy assessment. Methods: This prospective study, conducted at a tertiary hospital, analyzed 253 out of 6,893 patients with ultrasound BI-RADS 3-5 solid breast masses. For each mass, parallel or nonparallel orientation was assessed visually, and the orientation angle of breast mass was measured quantitatively on ultrasound image using built-in ultrasound software. Histopathological diagnosis served as the reference standard. Receiver Operating Characteristic (ROC) curve was plotted to determine the optimal cutoff value for the orientation angle in assessing breast malignancy. The diagnostic performances of the standard BI-RADS (using visual nonparallel orientation) and a modified BI-RADS (using the quantitative orientation angle) were compared for malignancy stratification. Results: McNemar testing demonstrated significant differences in diagnostic outcomes between visual nonparallel orientation assessment and quantitative angle measurement, as well as between the standard and modified ultrasound BI-RADS classifications (all Conclusion: The quantitative orientation angle is a more reproducible and objective measure. It can serve as a valuable complementary descriptor within ultrasound BI-RADS. Integrating this quantitative angle into a multi-descriptor assessment of breast masses improves the overall diagnostic performance.
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