Background parenchymal enhancement assessment: Inter- and intra-rater reliability across breast MRI sequences. Issue 114 (May 2019)

• Record Type: Journal Article
• Authors: Bignotti, Bianca; Calabrese, Massimo; Signori, Alessio; Tosto, Simona; Valdora, Francesca; Tagliafico, Alberto; Durando, Manuela; Mariscotti, Giovanna
• Is Part Of: European journal of radiology. Issue 114(2019)
• Page Start: 57
• Page End: 61
• Publication Date: 2019-05
• Subjects: BPE background parenchymal enhancement -- BI-RADS Breast Imaging-Reporting and Data System -- CE contrast-enhanced -- MIP Maximum intensity projections -- CI confidence interval; Breast -- Magnetic resonance imaging -- Reproducibility of results -- Background parenchymal enhancement; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2019.02.036
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: The combination of all CE MRI images showed the highest reliability of BPE assessment. MIP showed a high reliability with lower reading time compared to the combination of all CE MRI images. Abstract: Objective: To evaluate inter- and intra-rater reliability of background parenchymal enhancement (BPE) assessment across breast MRI sequences. Materials and methods: Institutional review board approval was obtained and the requirement for consent was waived. Three radiologists qualitatively categorized BPE on 150 breast MRI using a four-point scale (minimal, mild, moderate or marked) according to BI-RADS category system. According to MR-sequence used for the assessment of BPE, inter-rater and intra-rater reliability across a simulated reading strategy with four options was performed: (1) initial contrast-enhanced (CE) fat-suppressed T1-weighted images (2) initial CE subtracted images (3) maximum-intensity-projection (MIP) of the first CE subtracted images (4) combination of initial CE fat-suppressed T1-weighted, initial CE subtracted and MIP images. Raters repeated BPE assessment of 45 breast MRI four weeks after the initial assessment. Gwet's AC1 index with ordinal weights was used to assess reliabilities. Results: Gwet's index for the reliability among the three raters was 0.68 (0.63-0.74) using initial contrast-enhanced fat-suppressed T1 weighted images, 0.74 (0.69-0.80) using subtracted images, 0.80 (0.76-0.83) using MIP, 0.80 (0.77-0.84) using a combination of the initial contrast-enhanced fat-suppressed T1 weighted, initial contrast-enhanced subtracted and MIP images. Test-retest reliability was 0.81 (0.60–1.00) for rater 1, 0.77 (0.55-0.98) for rater 2, 0.79 (0.59-0.99) for rater 3 using the combination of initial contrast-enhanced fat-suppressed T1 weighted, initial contrast-enhanced subtracted and MIP images. Conclusions: Overall, the combination of all CE MRI images showed the highest reliability of BPE assessment. However, MIP showed a high reliability with lower reading time compared to the combination of all CE MRI images.