Iranian Journal of Radiology

Published by: Kowsar

Comparison of the Diagnostic Performance of Breast Ultrasound and CAD Using BI-RADS Descriptors and Quantitative Variables

Yumi Kim 1 , Bong Joo Kang 2 , * , Jung Min Lee 2 and Sung Hun Kim 2
Authors Information
1 Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
2 Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Article information
  • Iranian Journal of Radiology: January 31, 2019, 16 (1); e67729
  • Published Online: October 9, 2018
  • Article Type: Research Article
  • Received: February 20, 2018
  • Revised: June 19, 2018
  • Accepted: September 8, 2018
  • DOI: 10.5812/iranjradiol.67729

To Cite: Kim Y, Kang B J, Lee J M, Kim S H. Comparison of the Diagnostic Performance of Breast Ultrasound and CAD Using BI-RADS Descriptors and Quantitative Variables, Iran J Radiol. 2019 ; 16(1):e67729. doi: 10.5812/iranjradiol.67729.

Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Kim SM, Han H, Park JM, Choi YJ, Yoon HS, Sohn JH, et al. A comparison of logistic regression analysis and an artificial neural network using the BI-RADS lexicon for ultrasonography in conjunction with introbserver variability. J Digit Imaging. 2012;25(5):599-606. doi: 10.1007/s10278-012-9457-7. [PubMed: 22270787]. [PubMed Central: PMC3447099].
  • 2. Yoon JH, Kim MJ, Lee HS, Kim SH, Youk JH, Jeong SH, et al. Validation of the fifth edition BI-RADS ultrasound lexicon with comparison of fourth and fifth edition diagnostic performance using video clips. Ultrasonography. 2016;35(4):318-26. doi: 10.14366/usg.16010. [PubMed: 27184655]. [PubMed Central: PMC5040135].
  • 3. D'Orsi CJ; American College of Radiology. ACR BI-RADS atlas: Breast imaging reporting and data system. ACR, American College of Radiology; 2013.
  • 4. Hong AS, Rosen EL, Soo MS, Baker JA. BI-RADS for sonography: Positive and negative predictive values of sonographic features. AJR Am J Roentgenol. 2005;184(4):1260-5. doi: 10.2214/ajr.184.4.01841260. [PubMed: 15788607].
  • 5. Lee HJ, Kim EK, Kim MJ, Youk JH, Lee JY, Kang DR, et al. Observer variability of breast imaging reporting and data system (BI-RADS) for breast ultrasound. Eur J Radiol. 2008;65(2):293-8. doi: 10.1016/j.ejrad.2007.04.008. [PubMed: 17531417].
  • 6. Kim EK, Ko KH, Oh KK, Kwak JY, You JK, Kim MJ, et al. Clinical application of the BI-RADS final assessment to breast sonography in conjunction with mammography. AJR Am J Roentgenol. 2008;190(5):1209-15. doi: 10.2214/AJR.07.3259. [PubMed: 18430833].
  • 7. Sahiner B, Chan HP, Roubidoux MA, Hadjiiski LM, Helvie MA, Paramagul C, et al. Malignant and benign breast masses on 3D US volumetric images: Effect of computer-aided diagnosis on radiologist accuracy. Radiology. 2007;242(3):716-24. doi: 10.1148/radiol.2423051464. [PubMed: 17244717]. [PubMed Central: PMC2800986].
  • 8. Wang Y, Jiang S, Wang H, Guo YH, Liu B, Hou Y, et al. CAD algorithms for solid breast masses discrimination: Evaluation of the accuracy and interobserver variability. Ultrasound Med Biol. 2010;36(8):1273-81. doi: 10.1016/j.ultrasmedbio.2010.05.010. [PubMed: 20691917].
  • 9. Chabi ML, Borget I, Ardiles R, Aboud G, Boussouar S, Vilar V, et al. Evaluation of the accuracy of a computer-aided diagnosis (CAD) system in breast ultrasound according to the radiologist's experience. Acad Radiol. 2012;19(3):311-9. doi: 10.1016/j.acra.2011.10.023. [PubMed: 22310523].
  • 10. Dromain C, Boyer B, Ferre R, Canale S, Delaloge S, Balleyguier C. Computed-aided diagnosis (CAD) in the detection of breast cancer. Eur J Radiol. 2013;82(3):417-23. doi: 10.1016/j.ejrad.2012.03.005. [PubMed: 22939365].
  • 11. Drukker K, Gruszauskas NP, Sennett CA, Giger ML. Breast US computer-aided diagnosis workstation: Performance with a large clinical diagnostic population. Radiology. 2008;248(2):392-7. doi: 10.1148/radiol.2482071778. [PubMed: 18574139]. [PubMed Central: PMC2797650].
  • 12. Drukker K, Giger ML, Metz CE. Robustness of computerized lesion detection and classification scheme across different breast US platforms. Radiology. 2005;237(3):834-40. doi: 10.1148/radiol.2373041418. [PubMed: 16304105].
  • 13. Lee SE, Moon JE, Rho YH, Kim EK, Yoon JH. Which supplementary imaging modality should be used for breast ultrasonography? Comparison of the diagnostic performance of elastography and computer-aided diagnosis. Ultrasonography. 2017;36(2):153-9. doi: 10.14366/usg.16033. [PubMed: 27764908]. [PubMed Central: PMC5381849].
  • 14. Kim K, Song MK, Kim EK, Yoon JH. Clinical application of S-detect to breast masses on ultrasonography: A study evaluating the diagnostic performance and agreement with a dedicated breast radiologist. Ultrasonography. 2017;36(1):3-9. doi: 10.14366/usg.16012. [PubMed: 27184656]. [PubMed Central: PMC5207353].
  • 15. Lee JH, Seong YK, Chang CH, Ko EY, Cho BH, Ku J, Woo KG. Computer-aided lesion diagnosis in B-mode ultrasound by border irregularity and multiple sonographic features. SPIE Med Imag. 2013;8670. doi: 10.1117/12.2007452.
  • 16. Linda A, Zuiani C, Bazzocchi M, Furlan A, Londero V. Borderline breast lesions diagnosed at core needle biopsy: Can magnetic resonance mammography rule out associated malignancy? Preliminary results based on 79 surgically excised lesions. Breast. 2008;17(2):125-31. doi: 10.1016/j.breast.2007.11.002. [PubMed: 18083514].
  • 17. Sewell CW. Pathology of high-risk breast lesions and ductal carcinoma in situ. Radiol Clin North Am. 2004;42(5):821-30. v. doi: 10.1016/j.rcl.2004.03.013. [PubMed: 15337418].
  • 18. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74. [PubMed: 843571].
  • 19. Lazarus E, Mainiero MB, Schepps B, Koelliker SL, Livingston LS. BI-RADS lexicon for US and mammography: Interobserver variability and positive predictive value. Radiology. 2006;239(2):385-91. doi: 10.1148/radiol.2392042127. [PubMed: 16569780].
  • 20. American College of Radiology. Breast imaging reporting and data system. American College of Radiology; 2003.
  • 21. Rahbar G, Sie AC, Hansen GC, Prince JS, Melany ML, Reynolds HE, et al. Benign versus malignant solid breast masses: US differentiation. Radiology. 1999;213(3):889-94. doi: 10.1148/radiology.213.3.r99dc20889. [PubMed: 10580971].
  • 22. Cho E, Kim EK, Song MK, Yoon JH. Application of computer-aided diagnosis on breast ultrasonography: Evaluation of diagnostic performances and agreement of radiologists according to different levels of experience. J Ultrasound Med. 2018;37(1):209-16. doi: 10.1002/jum.14332. [PubMed: 28762552].
  • 23. Ko EY. S-detect™ in breast ultrasound: Initial experience. 2014. Available from:
  • 24. Jales RM, Sarian LO, Torresan R, Marussi EF, Alvares BR, Derchain S. Simple rules for ultrasonographic subcategorization of BI-RADS(R)-US 4 breast masses. Eur J Radiol. 2013;82(8):1231-5. doi: 10.1016/j.ejrad.2013.02.032. [PubMed: 23540948].
  • 25. Yoon JH, Kim MJ, Moon HJ, Kwak JY, Kim EK. Subcategorization of ultrasonographic BI-RADS category 4: Positive predictive value and clinical factors affecting it. Ultrasound Med Biol. 2011;37(5):693-9. doi: 10.1016/j.ultrasmedbio.2011.02.009. [PubMed: 21458145].
  • 26. Burivong W, Amornvithayacharn O. Accuracy of subcategories A, B, C in BI-RADS 4 lesions by combined mammography and breast ultrasound findings. Afr J Med Med Sci. 2011;2(3):728-33.
  • 27. Kim SM, Kim Y, Jeong K, Jeong H, Kim J. Logistic LASSO regression for the diagnosis of breast cancer using clinical demographic data and the BI-RADS lexicon for ultrasonography. Ultrasonography. 2018;37(1):36-42. doi: 10.14366/usg.16045. [PubMed: 28618771]. [PubMed Central: PMC5769953].

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