Breast MRI BI-RADS assessments and abnormal interpretation rates by clinical indication in US community practices
| Autor: | Rochelle, Michele C., Miglioretti, Diana L., Sprague, Brian L., Lehman, Constance D., Kerlikowske, Karla, Ichikawa, Laura, Yankaskas, Bonnie C., Wernli, Karen J., Joe, Bonnie N., DeMartini, Wendy B., Lee, Christoph I. |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Adolescent Clinical Sciences Breast Neoplasms audit Practice Patterns quality assurance Medical Oncology Sensitivity and Specificity Young Adult Risk Factors Clinical Research Breast Cancer Prevalence Humans skin and connective tissue diseases Aged Cancer Physicians' Breast magnetic resonance imaging Prevention Reproducibility of Results Middle Aged Magnetic Resonance Imaging Nuclear Medicine & Medical Imaging Practice Guidelines as Topic Biomedical Imaging Radiology Mammography |
| Zdroj: | Academic radiology, vol 21, iss 11 |
| Popis: | Rationale and objectivesAs breast magnetic resonance imaging (MRI) use grows, benchmark performance parameters are needed for auditing and quality assurance purposes. We describe the variation in breast MRI abnormal interpretation rates (AIRs) by clinical indication among a large sample of US community practices.Materials and methodsWe analyzed data from 41 facilities across five Breast Cancer Surveillance Consortium imaging registries. Each registry obtained institutional review board approval for this Health Insurance Portability and Accountability Act compliant analysis. We included 11,654 breast MRI examinations conducted in 2005-2010 among women aged 18-79 years. We categorized clinical indications as 1) screening, 2) extent of disease, 3) diagnostic (eg, breast symptoms), and 4) other (eg, short-interval follow-up). We characterized assessments as positive (ie, Breast Imaging Reporting and Data System [BI-RADS] 0, 4, and 5) or negative (ie, BI-RADS 1, 2, and 6) and provide results with BI-RADS 3 categorized as positive and negative. We tested for differences in AIRs across clinical indications both unadjusted and adjusted for patient characteristics and registry and assessed for changes in AIRs by year within each clinical indication.ResultsWhen categorizing BI-RADS 3 as positive, AIRs were 21.0% (95% confidence interval [CI], 19.8-22.3) for screening, 31.7% (95% CI, 29.6-33.8) for extent of disease, 29.7% (95% CI, 28.3-31.1) for diagnostic, and 27.4% (95% CI, 25.0-29.8) for other indications (P < .0001). When categorizing BI-RADS 3 as negative, AIRs were 10.5% (95% CI, 9.5-11.4) for screening, 21.8% (95% CI, 19.9-23.6) for extent of disease, 17.7% (95% CI, 16.5-18.8) for diagnostic, and 13.3% (95% CI, 11.6-15.2) for other indications (P < .0001). The significant differences in AIRs by indication persisted even after adjusting for patient characteristics and registry (P < .0001). In addition, for most indications, there were no significant changes in AIRs over time.ConclusionsBreast MRI AIRs differ significantly by clinical indication. Practices should stratify breast MRI examinations by indication for quality assurance and auditing purposes. |
| Databáze: | OpenAIRE |
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