Unenhanced Breast MRI With Diffusion-Weighted Imaging for Breast Cancer Detection: Effects of Training on Performance and Agreement of Subspecialty Radiologists.

Autor:	Kim YS; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Lee SH; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Kim SY; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Kim ES; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Park AR; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Chang JM; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Park VY; Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea., Yoon JH; Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea., Kang BJ; Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Yun B; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.; Department of Radiology, Seoul National University Bundang Hospital, Seoul, Republic of Korea., Kim TH; Department of Radiology, Ajou University Medical Center, Suwon, Republic of Korea., Ko ES; Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul, Republic of Korea., Chu AJ; Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea., Kim JY; Department of Radiology, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea., Youn I; Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Chae EY; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Choi WJ; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Kim HJ; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Kang SH; Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea., Ha SM; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. su3ha5@hanmail.net., Moon WK; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
Jazyk:	angličtina
Zdroj:	Korean journal of radiology [Korean J Radiol] 2024 Jan; Vol. 25 (1), pp. 11-23.
DOI:	10.3348/kjr.2023.0528
Abstrakt:	Objective: To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). Materials and Methods: A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm² was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive. The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). Results: Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4-79.9), 90.8% (95% CI: 85.6-94.2), and 83.5% (95% CI: 78.6-87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8-97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9-89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1-79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52-0.63) before training and 0.68 (95% CI: 0.62-0.74) after training, with a difference of 0.11 (95% CI: 0.02-0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69-0.74) before training and 0.79 (95% CI: 0.76-0.80) after training ( P = 0.002). Conclusion: Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI. Competing Interests: Vivian Youngjean Park and Woo Jung Choi, the editor board member of the Korean Journal of Radiology, were not involved in the editorial evaluation or decision to publish this article. All authors have declared no conflicts of interest. (Copyright © 2023 The Korean Society of Radiology.)
Databáze:	MEDLINE
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