Radiologists' Performance in the ACR Breast MR With Guided Biopsy Course

Abstract

The ACR Education Center's Breast MR With Guided Biopsy course is designed to provide radiologists with an intensive, hands-on experience in interpreting breast MR. The aim of this study was to describe radiologists' performance in breast MR interpretation by case clinical indication, lesion type, and BI-RADS(®) assessment to inform future educational efforts. Data from 16 consecutive courses held from 2009 to 2012 at the ACR Education Center were analyzed. For each MR case, the clinical indication (screening vs diagnostic), background parenchymal enhancement, and lesion type (mass vs nonmass enhancement) were recorded. Participant case BI-RADS assessments were categorized as either correct or incorrect in relation to expert-opinion BI-RADS assessments. Participants' interpretive accuracy on the basis of study indication, lesion type, and background parenchymal enhancement is reported. Data from 745 course participants over 3 years were analyzed. Of the 96 MR cases included in the analysis, 58% (n = 50) were indicated for screening and 42% (n = 46) for diagnostic purposes. Participants provided correct BI-RADS assessments for 79% of screening cases (32,399 of 41,249) and 74% of diagnostic cases (20,888 of 28,106). Participants more accurately assessed screening compared with diagnostic MR cases (P < .0001) and masses compared with nonmass enhancement (P < .0001). There was no statistically significant difference in performance on the basis of background parenchymal enhancement. Practicing radiologists perform more accurately on screening compared with diagnostic MR and when evaluating masses as opposed to areas of nonmass enhancement. Future case-based breast MR education efforts should emphasize strategies for interpreting diagnostic breast MR cases and evaluating nonmass enhancement.