Effect of Training with the American College of Radiology Breast Imaging Reporting and Data System Lexicon on Mammographic Interpretation Skills in Developing Countries 1

Abstract

Rationale and Objectives The authors evaluated the effect of training in the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) lexicon on the interpretive skills of radiologists evaluating screening mammograms in Ukraine. Materials and Methods As part of a program to improve breast cancer detection and treatment in Ukraine, a series of training sessions was given to a group of radiologists across Ukraine to improve their interpretive skills in screening mammography. The training sessions focused on the use of the lexicon and assessment categories developed by the ACR BI-RADS committee. Participants ( n = 14) evaluated 30 test screening mammograms before and after the training sessions. The test sets were randomly selected from a larger collection of training sets containing normal, benign, and abnormal mammograms. False-positive, false-negative, true-positive, and true-negative evaluations were determined, and sensitivity, specificity, and positive predictive values were calculated for each participant before and after training. Results The mean baseline sensitivity, specificity, and positive predictive values were 50%, 77%, and 43%, respectively. Each of these measures of interpretive skills improved significantly after training in the use of the lexicon, to 87%, 89%, and 78% ( P < .0001, P < .01, and P < .0001, respectively). Conclusion As the use of mammography spreads throughout developing countries, it is essential to address training and educational needs, as well as equipment needs. The ACR BI-RADS lexicon provides a systematic and efficient method for training radiologists to interpret screening mammograms. Educating radiologists on the use of this lexicon proved an effective way to improve their interpretive skills in screening mammography.