Diagnostic Performance of Kaiser score in MRI BI-RADS 3 Lesions: A Promising tool to reduce unnecessary biopsies

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-02-01 DOI:10.1016/j.ejrad.2024.111872

Eleonora Ostillio , Serena Carriero , Davide Razzini , Léon Groenhoff , Anna Tambasco , Chiara Airoldi , Anna Lucia Clelia Gambaro , Alessandro Carriero , Pietro Costantini

{"title":"Diagnostic Performance of Kaiser score in MRI BI-RADS 3 Lesions: A Promising tool to reduce unnecessary biopsies","authors":"Eleonora Ostillio , Serena Carriero , Davide Razzini , Léon Groenhoff , Anna Tambasco , Chiara Airoldi , Anna Lucia Clelia Gambaro , Alessandro Carriero , Pietro Costantini","doi":"10.1016/j.ejrad.2024.111872","DOIUrl":null,"url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate the possibility of reducing unnecessary biopsies in patients with BI-RADS 3 lesions by implementing Kaiser score (KS).</div></div><div><h3>METHOD</h3><div>In this retrospective, single-center study, we included 79 female patients with BI-RADS 3 lesions and risk factors who underwent biopsy following magnetic resonance imaging. Three readers (two experienced breast radiologists and a radiology resident) blinded evaluated the lesions using KS. Lesions with a KS ≤ 4 were considered benign. Results were compared with the histopathological findings (gold standard) assessing sensitivity and specificity along with 95 % confidence intervals (CI) for each reader. Inter-reader agreement was assessed using Fleiss’ kappa with 95 % CIs. Moreover, Cohen’s kappa was used to assess concordance between two readers at time.</div></div><div><h3>RESULTS</h3><div>79 female patients (mean age, 50.9 ± 12.2 (standard deviation)) were evaluated. The area under the receiver operating characteristic curve for the three readers was excellent: 0.99, 0.99, and 0.90), respectively. The sensitivity of the two breast radiologists and the resident was 0.92 (95 % CI: 0.62 – 0.99), 1.00 (95 % CI: 0.95 – 1.00) and 0.75 (95 % CI: 0.42 – 0.95), respectively, while the specificity was 1.00 (95 % CI: 0.95–––1.00), 0.99 (95 % CI: 0.92 – 1.00), and 1.00 (95 % CI: 0.95 – 1.00) respectively. By using a KS ≤ 4 value to indicate benignity, 66 to 67 biopsies (84 to 85 % of all the biopsies) would have been avoided. Inter-reader concordance via Fleiss’ kappa was 0.792 (95 % CI: 0.68 – 0.91).</div></div><div><h3>CONCLUSIONS</h3><div>The implementation of KS could have spared 84–85% of biopsies, proving to be a quick, user-friendly tool with strong inter-observer agreement and high specificity.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111872"},"PeriodicalIF":3.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X24005886","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

PURPOSE

To evaluate the possibility of reducing unnecessary biopsies in patients with BI-RADS 3 lesions by implementing Kaiser score (KS).

METHOD

In this retrospective, single-center study, we included 79 female patients with BI-RADS 3 lesions and risk factors who underwent biopsy following magnetic resonance imaging. Three readers (two experienced breast radiologists and a radiology resident) blinded evaluated the lesions using KS. Lesions with a KS ≤ 4 were considered benign. Results were compared with the histopathological findings (gold standard) assessing sensitivity and specificity along with 95 % confidence intervals (CI) for each reader. Inter-reader agreement was assessed using Fleiss’ kappa with 95 % CIs. Moreover, Cohen’s kappa was used to assess concordance between two readers at time.

RESULTS

79 female patients (mean age, 50.9 ± 12.2 (standard deviation)) were evaluated. The area under the receiver operating characteristic curve for the three readers was excellent: 0.99, 0.99, and 0.90), respectively. The sensitivity of the two breast radiologists and the resident was 0.92 (95 % CI: 0.62 – 0.99), 1.00 (95 % CI: 0.95 – 1.00) and 0.75 (95 % CI: 0.42 – 0.95), respectively, while the specificity was 1.00 (95 % CI: 0.95–––1.00), 0.99 (95 % CI: 0.92 – 1.00), and 1.00 (95 % CI: 0.95 – 1.00) respectively. By using a KS ≤ 4 value to indicate benignity, 66 to 67 biopsies (84 to 85 % of all the biopsies) would have been avoided. Inter-reader concordance via Fleiss’ kappa was 0.792 (95 % CI: 0.68 – 0.91).

CONCLUSIONS

The implementation of KS could have spared 84–85% of biopsies, proving to be a quick, user-friendly tool with strong inter-observer agreement and high specificity.

查看原文本刊更多论文

Kaiser评分在MRI BI-RADS 3病变中的诊断性能：一种减少不必要活检的有前途的工具。

目的：评价采用Kaiser评分（KS）减少BI-RADS 3型病变患者不必要活检的可能性。方法：在这项回顾性的单中心研究中，我们纳入了79名患有BI-RADS 3病变和危险因素的女性患者，这些患者在磁共振成像后接受了活检。三位读者（两位经验丰富的乳腺放射科医生和一位放射科住院医师）使用KS对病变进行盲法评估。KS≤4视为良性病变。将结果与组织病理学结果（金标准）进行比较，评估灵敏度和特异性，以及每个阅读器的95%置信区间（CI）。使用Fleiss kappa评估读者间一致性，ci为95%。此外，Cohen's kappa被用来评估两个读者之间的一致性。结果：共纳入79例女性患者，平均年龄50.9±12.2（标准差）。三种读卡器的受者工作特征曲线下面积分别为0.99、0.99和0.90)。两名乳腺放射科医师和住院医师的敏感性分别为0.92 （95% CI: 0.62 ~ 0.99）、1.00 （95% CI: 0.95 ~ 1.00）和0.75 (95% CI: 0.42 ~ 0.95)，特异性分别为1.00 （95% CI: 0.95 ~ 1.00）、0.99 （95% CI: 0.92 ~ 1.00）和1.00 （95% CI: 0.95 ~ 1.00）。通过使用KS≤4值表示良性，可以避免66 ~ 67例活检（占所有活检的84 ~ 85%）。通过Fleiss' kappa检测的读者间一致性为0.792 （95% CI: 0.68 - 0.91）。结论：实施KS可以避免84-85%的活检，证明是一种快速，用户友好的工具，具有很强的观察者间一致性和高特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.