Roychowdhury Prithwijit, Vijayaraghavan Gopal R, Roubil John, Williams Imani M, Siddiqui Efaza, Vedantham Srinivasan
Department of Medicine, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA 01655.
Department of Radiology, UMass Memorial Healthcare, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA 01655.
Biomed J Sci Tech Res. 2022 Feb;41(5):33086-33092. doi: 10.26717/BJSTR.2022.41.006668. Epub 2022 Feb 14.
BI-RADS 3 is an established assessment category in which the probability of malignancy is equal to or less than 2%. However, monitoring adherence to imaging criteria can be challenging and there are few established benchmarks for auditing BI-RADS 3 assignments. In this study, we explore some parameters that could serve as useful tools for quality control and clinical practice management.
This retrospective study covered a 4-year period (Jan 2014-Dec 2017) and included all women over 40 years who were recalled from a screening exam and had an initial assignment of BI-RADS 3 (probably benign) category after diagnostic workup. A follow-up period of 2 years following the assignment of BI-RADS 3 was used for quantitative quality control metrics.
Among 135,765 screening exams, 13,453 were recalled and 1,037 BI-RADS 3 cases met inclusion criteria. The follow-up rate at 24 months was 86.7%. The upgrade rate was 7.4% (77/1,037) [CI: 5.9-9.2%] and the PPV3 was 33.8% (26/77) [CI: 23.4-45.5%]. The cancer yield was 2.51% (26/1,037) [CI: 1.64-3.65%] and did not differ (p=0. 243) from the 2% probability of malignancy. The initial BI-RADS3 per screening exam and per recall from screening were 0.76% (1,037/135,765) [CI: 0.72-0.81%] and 7.7% (1,037/13,453) [CI: 7.26-8.17%], respectively.
Regular audit of BIRADS 3 metrics has the potential to provide additional insights for clinical practice management. Data from varied clinical settings with input from an expert committee could help establish benchmarks for these metrics.
BI-RADS 3是一个既定的评估类别，其中恶性肿瘤的概率等于或小于2%。然而，监测对成像标准的遵守情况可能具有挑战性，并且几乎没有既定的基准来审核BI-RADS 3分类。在本研究中，我们探索了一些可作为质量控制和临床实践管理有用工具的参数。
这项回顾性研究涵盖了4年时间（2014年1月至2017年12月），纳入了所有40岁以上从筛查检查中被召回且在诊断检查后最初被分类为BI-RADS 3（可能为良性）类别的女性。在BI-RADS 3分类后2年的随访期用于定量质量控制指标。
在135,765次筛查检查中，13,453次被召回，1,037例BI-RADS 3病例符合纳入标准。24个月时的随访率为86.7%。升级率为7.4%（77/1,037）[置信区间：5.9 - 9.2%]，PPV3为33.8%（26/77）[置信区间：23.4 - 45.5%]。癌症检出率为2.51%（26/1,037）[置信区间：1.64 - 3.65%]，与2%的恶性肿瘤概率无差异（p = 0.243）。每次筛查检查和每次从筛查中召回的初始BI-RADS 3分别为0.76%（1,037/135,765）[置信区间：0.72 - 0.81%]和7.7%（1,037/13,453）[置信区间：7.26 - 8.17%]。
定期审核BI-RADS 3指标有可能为临床实践管理提供更多见解。来自不同临床环境的数据以及专家委员会的意见有助于为这些指标建立基准。
