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

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Abstract

Background

To assess inter-reader agreement for US BI-RADS descriptors using S-Detect: a computer-guided decision-making software 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) detected at US were randomly and independently assessed according to the BI-RADS US lexicon, without and with S-Detect, by five independent reviewers. US-guided core-biopsy and 24-month follow-up were considered as standard of reference. Kappa statistics were calculated to assess inter-operator agreement, between the baseline and after S-Detect evaluation. Agreement was 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 improvement of 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 features showed the worst agreement rate (poor). After S-Detect evaluation, all variables but isoechoic pattern showed an agreement class 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-RADS US lexicon but evaluation of margin and echo pattern needs to be further improved, particularly isoechoic pattern.

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Authors and Affiliations

  1. Department of Biomedicine, Neuroscience and Advanced Diagnostic (Bi.N.D.), University Hospital “Policlinico P. Giaccone”, Via Del Vespro 129, 90127, Palermo, Italy

    Tommaso Vincenzo Bartolotta, Alessia Angela Maria Orlando, Maria Laura Di Vittorio, Francesco Amato, Mariangela Dimarco & Raffaele Ienzi

  2. Department of Radiology, Fondazione Istituto Giuseppe Giglio Ct.da Pietrapollastra, Via Pisciotto, 90015, Cefalù (Palermo), Italy

    Tommaso Vincenzo Bartolotta

  3. Department of Sciences for Health Promotion and Mother, Child Care, University Hospital “Policlinico P. Giaccone”, Via Del Vespro 129, 90127, Palermo, Italy

    Domenica Matranga

Authors
  1. Tommaso Vincenzo Bartolotta
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  2. Alessia Angela Maria Orlando
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  3. Maria Laura Di Vittorio
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  4. Francesco Amato
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  7. Raffaele Ienzi
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Correspondence to Alessia Angela Maria Orlando.

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Conflict of interest

Tommaso Vincenzo Bartolotta is lecturer and scientific advisor for Samsung. Other authors declare that they have no conflict of interest.

Ethics approval

This research was supported by research equipment from SAMSUNG MEDISON Co., Ltd. Institutional Review Board approval was granted for the use of all data in this study. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study. Permission was obtained from the hospital for patients’ medical records review.

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Bartolotta, T.V., Orlando, A.A.M., Di Vittorio, M.L. et al. S-Detect characterization of focal solid breast lesions: a prospective analysis of inter-reader agreement for US BI-RADS descriptors. J Ultrasound 24, 143–150 (2021). https://doi.org/10.1007/s40477-020-00476-5

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