S‑Detect characterization of focal solid breast lesions: a prospective　analysis of inter‑reader agreement for US BI‑RADS descriptors

摘要

Background To assess inter-reader agreement for US BI-RADS descriptors using S-Detect: a computer-guided decisionmakingsoftware assisting in US morphologic analysis.Methods 73 solid focal breast lesions (FBLs) (mean size: 15.9 mm) in 73 consecutive women (mean age: 51 years) detectedat US were randomly and independently assessed according to the BI-RADS US lexicon, without and with S-Detect, by fiveindependent reviewers. US-guided core-biopsy and 24-month follow-up were considered as standard of reference. Kappastatistics were calculated to assess inter-operator agreement, between the baseline and after S-Detect evaluation. Agreementwas graded as poor (≤ 0.20), moderate (0.21–0.40), fair (0.41–0.60), good (0.61–0.80), or very good (0.81–1.00).Results 33/73 (45.2%) FBLs were malignant and 40/73 (54.8%) FBLs were benign. A statistically significant improvementof inter-reader agreement from fair to good with the use of S-Detect was observed for shape (from 0.421 to 0.612) and orientation(from 0.417 to 0.7) (p < 0.0001) and from moderate to fair for margin (from 0.204 to 0.482) and posterior features(from 0.286 to 0.522) (p < 0.0001). At baseline analysis isoechoic (0.0485) and heterogeneous (0.1978) echo pattern, microlobulated(0.1161) angular (0.1204) and spiculated (0.1692) margins and combined pattern (0.1549) for posterior featuresshowed the worst agreement rate (poor). After S-Detect evaluation, all variables but isoechoic pattern showed an agreementclass upgrade with a statistically significant improvement of inter-reader agreement (p < 0.0001).Conclusions S-Detect significantly improved inter-reader agreement in the assessment of FBLs according to the BI-RADSUS lexicon but evaluation of margin and echo pattern needs to be further improved, particularly isoechoic pattern.