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Inter-reader agreement of breast magnetic resonance imaging and contrast-enhanced mammography in breast cancer diagnosis: a multi-reader retrospective study

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Abstract

Objective

Breast magnetic resonance imaging (MRI) and contrast-enhanced mammography (CEM) are nowadays used in breast imaging but studies about their inter-reader agreement are lacking. Therefore, we compared the inter-reader agreement of CEM and MRI in breast cancer diagnosis in the same patients.

Methods

Breast MRI and CEM exams performed in a single center (09/2020–09/2021) for an IRB-approved study were retrospectively and independently evaluated by four radiologists of two different centers with different levels of experience who were blinded to the clinical and other imaging data. The reference standard was the histological diagnosis or at least 1-year negative imaging follow-up. Inter-reader agreement was examined using Cohen’s and Fleiss’ kappa (κ) statistics and compared with the Wald test.

Results

Of the 750 patients, 395 met inclusion criteria (44.5 ± 14 years old), with 752 breasts available for CEM and MRI. Overall agreement was moderate (κ = 0.60) for MRI and substantial (κ = 0.74) for CEM. For expert readers, the agreement was substantial (κ = 0.77) for MRI and almost perfect (κ = 0.82) for CEM; for non-expert readers was fair (κ = 0.39); and for MRI and moderate (κ = 0.57) for CEM. Pairwise agreement between expert readers and non-expert readers was moderate (κ = 0.50) for breast MRI and substantial (κ = 0.74) for CEM and it showed a statistically superior agreement of the expert over the non-expert readers only for MRI (p = 0.011) and not for CEM (p = 0.062).

Conclusions

The agreement of CEM was superior to that of MRI (p = 0.012), including for both expert (p = 0.031) and non-expert readers (p = 0.005).

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Data availability

Enquiries about data availability should be directed to the corresponding author.

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Author information

Authors and Affiliations

  1. Breast Imaging Division, IEO European Institute of Oncology IRCCS, Milan, Italy

    Filippo Pesapane, Luca Nicosia, Anna Bozzini, Anna Rotili, Silvia Penco, Maria Pizzamiglio & Enrico Cassano

  2. Department of Radiology, King’s College Hospital NHS Foundation Trust, London, UK

    Priyan Tantrige

  3. Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), 6900, Lugano, Switzerland

    Simone Schiaffino

  4. Department of Radiology, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy

    Alessandro Liguori, Marta Montesano & Gianpaolo Carrafiello

  5. Department of Radiology, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, 20131, Milan, Italy

    Michaela Cellina & Marcello Orsi

  6. Department of Health Sciences, University of Milan, 20122, Milan, Italy

    Gianpaolo Carrafiello

Authors
  1. Filippo Pesapane
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  2. Luca Nicosia
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  14. Enrico Cassano
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Correspondence to Filippo Pesapane.

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Pesapane, F., Nicosia, L., Tantrige, P. et al. Inter-reader agreement of breast magnetic resonance imaging and contrast-enhanced mammography in breast cancer diagnosis: a multi-reader retrospective study. Breast Cancer Res Treat 202, 451–459 (2023). https://doi.org/10.1007/s10549-023-07093-w

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  • DOI: https://doi.org/10.1007/s10549-023-07093-w

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