Ultrasonography.
2019 Apr;38(2):172-180. 10.14366/usg.18012.
Interobserver agreement in breast ultrasound categorization in the Mammography and Ultrasonography Study for Breast Cancer Screening Effectiveness (MUST-BE) trial: results of a preliminary study
- Affiliations
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- 1Department of Radiology and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
- 2Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. grace@schmc.ac.kr
- 3Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
- 4Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
- 5Department of Radiology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
- 6Department of Radiology, Inje University Busan Paik Hospital, Busan, Korea.
- 7Department of Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
- 8National Cancer Control Institute, National Cancer Center, Goyang, Korea.
- KMID: 2447354
- DOI: http://doi.org/10.14366/usg.18012
Abstract
- PURPOSE
The purpose of this study was to record and evaluate interobserver agreement as quality control for the modified categorization of screening breast ultrasound developed by the Alliance for Breast Cancer Screening in Korea (ABCS-K) for the Mammography and Ultrasonography Study for Breast Cancer Screening Effectiveness (MUST-BE) trial.
METHODS
Eight breast radiologists with 4-16 years of experience participated in 2 rounds of quality control testing for the MUST-BE trial. Two investigators randomly selected 125 and 100 cases of breast lesions with different ratios of malignant and benign lesions. Two versions of the modified categorization were tested. The initially modified classification was developed after the first quality control workshop, and the re-modified classification was developed after the second workshop. The re-modified categorization established by ABCS-K added size criteria and the anterior-posterior ratio compared with the initially modified classification. After a brief lecture on the modified categorization system prior to each quality control test, the eight radiologists independently categorized the lesions using the modified categorization. Interobserver agreement was measured using kappa statistics.
RESULTS
The overall kappa values for the modified categorizations indicated moderate to substantial degrees of agreement (initially modified categorization and re-modified categorization: κ=0.52 and κ=0.63, respectively). The kappa values for the subcategories of category 4 were 0.37 (95% confidence interval [CI], 0.24 to 0.52) and 0.39 (95% CI, 0.31 to 0.49), respectively. The overall kappa values for both the initially modified categorization and the re-modified categorization indicated a substantial degree of agreement when dichotomizing the interpretation as benign or suspicious.
CONCLUSION
The preliminary results demonstrated acceptable interobserver agreement for the modified categorization.
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