Effect of training on ultrasonography (US) BI-RADS features for radiology residents: a multicenter study comparing performances after training
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To evaluate the effect of training radiology residents on breast ultrasonography (US) according to the Breast Imaging Reporting And Data System (BI-RADS) and the factors that influence the training effect.
This multicenter, prospective study was approved by eight institutional review boards. From September 2013 to July 2014, 248 breast masses in 227 women were included for US image acquisition. Representative B-mode and video images of the breast masses were recorded, among which 54 cases were included in the education set and 66 in the test set. Sixty-one radiology residents scheduled for breast imaging training individually reviewed the test set, immediately before, 1 month after, and 6 months after training. Diagnostic performances and US descriptors of the residents were evaluated and compared against those of expert radiologists.
Agreements between residents and experienced radiologists showed improvement after training, while agreements between post-training and post-6-month training descriptors did not show significant differences (all p > 0.05, respectively). Sensitivity, negative predictive value (NPV), and AUC were significantly improved for residents post-training and post-6-month training (all p < 0.05), while approximating the performances of expert radiologists except for AUC (0.836, 0.840, and 0.908, respectively, p < 0.05). Low levels of pre-training AUC, total number of breast US examinations, and the number of sessions per week that residents were involved in were factors influencing the improvement of AUC.
Training using education material dedicated for breast US imaging effectively improved the diagnostic performances of radiology residents and agreements with experienced radiologists on US BI-RADS features.
• Agreements on lesion descriptors between residents and experienced radiologists showed improvement after training, regardless of test point.
• Sensitivity, NPV, and AUC were significantly improved for residents in post-training and post-6-month training (all p < 0.05).
• Low levels of pre-training AUC, total number of breast US examinations, and the number of sessions per week that residents were involved in were factors influencing the improvement of AUC.
KeywordsBreast Ultrasound Education Residency Training
American College of Radiology
Area under the receiver operating characteristic curve
Breast Imaging Reporting And Data System
Negative predictive value
Positive predictive value
This study has received funding by the Korean Society of Breast Imaging & Korean Society for Breast Screening (KSBI & KSFBS-2013-No.001).
Compliance with ethical standards
The scientific guarantor of this publication is Min Jung Kim.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise, Hye Sun Lee.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
Study subjects or cohorts overlap
Some study subjects or cohorts have been previously reported in Ultrasound Med Biol 2016;42(9):2083–2088.
The performances of the experienced radiologists in reviewing static and real-time video clips obtained from the patients included in this study have been published. While our study focuses on comparing the performances and agreements between residents and experienced radiologists on breast US examinations, the prior study focuses on comparing the diagnostic performances between static and video clip images.
• cross-sectional study/observational
• multicenter study
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