Mammography Lexicon Research Articles

Automated classification of BI-RADS in textual mammography reports

The main purpose of this paper is to process key information in medical text records and also classifypatients, per different levels of breast imaging-reporting and data system (BI-RADS). The BI-RADS is a scheme for thestandardization of breast imaging reports. Therefore, medical text mining is employed to classify mammography reportssupported BI-RADS. In this research, a new method is proposed for automated BI-RADS classifications extraction fromtextual reports and improves the therapeutic procedures. At first, a mammography lexicon is employed for choosingkeywords from medical text reports. Word2vec and term frequency inverse document frequency (TFIDF) techniques areused for extracting features, finally, they are combined with the hospital information system (HIS) reports and calledWith-HIS. The different classifiers like multiclass support vector machine (SVM), naïve Bayesian (NB), extreme gradientboosting (XGBoost), and multilevel fuzzy min-max neural network (MLF) are used so as to compare the accuracy ofWith-HIS and without HIS (called Without-HIS). The results are confirmed that using HIS beside the proposed approach(Word2vec +TFIDF) encompasses a significant effect on the accuracy of medical text classification. Accuracy within theproposed method with MLF classifier is 0.89% but Without-HIS is 0.85%.

Current Status and Future of BI-RADS in Multimodality Imaging, From theAJRSpecial Series on Radiology Reporting and Data Systems

BI-RADS is a communication and data tracking system that has evolved since its inception as a brief mammography lexicon and reporting guide into a robust structured reporting platform and comprehensive quality assurance tool for mammography, ultrasound, and MRI. Consistent and appropriate use of the BI-RADS lexicon terminology and assessment categories effectively communicates findings, estimates the risk of malignancy, and provides management recommendations to patients and referring clinicians. The impact of BI-RADS currently extends internationally through six language translations. A condensed version has been proposed to facilitate a phased implementation of BI-RADS in resource-constrained regions. The primary advance of the 5th edition of BI-RADS is harmonization of the lexicon terms across mammography, ultrasound, and MRI. Harmonization has also been achieved across these modalities for the reporting structure, assessment categories, management recommendations, and data tracking system. Areas for improvement relate to certain common findings that lack lexicon descriptors and a need for further clarification of proper use of category 3. BI-RADS is anticipated to continue to evolve for application to a range of emerging breast imaging modalities.

Proceedings of the meeting “Update in Breast Imaging”, 22-23.11.2013, Ostend, Belgium

The American College of Radiology (ACR) BI-RADS Breast Imaging Reporting Lexicon for mam mography is in its fifth edition. Since the first mammography lexicon publication, there had been the addition of both the first editions of the Ultrasound and MRI Lexicons. The updated ACR BI-RADS Breast Imaging Reporting Lexicon for Mammography and Ultrasound has an expected publication date of winter, 2013. Evidence-based information on both mammography and ultrasound (US) descriptors and incorporation of new technology since the last BIRADS Lexicon publications have been incorporated into the new Lexicons with hyperlinks to the mammography and ultrasound literature. The terms for both mammography and US have been adapted to allow harmonization of terms between the Lexicons, including harmonization with the breast MRI Lexicon. The Chairs of the ACR BIRADS Lexicons are Dr. Edward A. Sickles for Mammography and Dr. Ellen B. Mendleson for Ultrasound.

Mammographic Screening in Women at Increased Risk of Breast Cancer after Treatment of Hodgkin’s Disease

Treatment regimens for Hodgkin's disease (HD) that have included radiation to lymph node regions in the thorax have contributed to high rates of long-term disease-free survival. However, incidental radiation exposure of breast tissue in young women has significantly increased the risk of breast cancer compared to expected rates in the general population. After informing patients about risks associated with previous treatment of HD, we studied screening mammograms and call-back rates in women at increased risk for developing breast cancer at a younger age. We contacted by mail a cohort of 291 women between 25 and 55 years of age who had received thoracic irradiation before 35 years of age for HD with or without chemotherapy. Subjects were offered information about risks identified after HD therapy with questionnaires to assess response to this information. Ten patients refused participation, 93 did not respond, and 21 were excluded after they reported a prior diagnosis of invasive (1) or in situ (2) breast cancer. One hundred and sixty seven women received information about secondary breast cancer risk and were advised to initiate or maintain mammographic screening. Available mammograms were reviewed by two radiologists and classified according to the ACR BI-RADS Mammography Lexicon. Abnormal findings were correlated to pathology results from biopsies. One hundred and fifteen subjects reported that they obtained new mammograms during the period of the study. Ninety-nine were available for secondary review. Patients were studied an average of 16.9 years after HD treatment (Range: 4.5-32.5 years) at an average of 41 years of age (range 25-55 years). High density breast tissue was identified in 60% (60/99). Seventeen of the women (17.2%) were recalled for further imaging. This was more common in women with heterogeneously dense breast tissue. Seven of those recalled (41%) were advised to undergo biopsies that identified ductal carcinoma in situ (DCIS) in one and benign findings in the others. Among 16 women whose mammograms were unavailable for review, three were diagnosed with DCIS; two of these had microscopic evidence of invasive breast cancer. The four in situ or microinvasive cancers were diagnosed in the study participants at 25-40 years of age and from 5 to 23 years after HD therapy. Biopsies were performed because mammograms detected microcalcifications without palpable abnormality in three of these cases. Women who have had thoracic nodal irradiation for Hodgkin's disease have an increased risk of developing secondary breast cancer at an unusually young age. As expected in younger women, high density breast tissue was common on mammography, and the recall and biopsy rates were unusually high. However, early mammographic screening facilitated diagnosis of in situ and early invasive cancer in 3.5% of our subjects.

Breast Imaging Reporting and Data System: inter- and intraobserver variability in feature analysis and final assessment.

We sought to evaluate the use of the Breast Imaging Reporting and Data System (BI-RADS) standardized mammography lexicon among and within observers and to distinguish variability in feature analysis from variability in lesion management. Five experienced mammographers, not specifically trained in BI-RADS, used the lexicon to describe and assess 103 screening mammograms, including 30 (29%) showing cancer, and a subset of 86 mammograms with diagnostic evaluation, including 23 (27%) showing cancer. A subset of 13 screening mammograms (two with malignant findings, 11 with diagnostic evaluation) were rereviewed by each observer 2 months later. Kappa statistics were calculated as measures of agreement beyond chance. After diagnostic evaluation, the interobserver kappa values for describing features were as follows: breast density, 0.43; lesion type, 0.75; mass borders, 0.40; special cases, 0.56; mass density, 0.40; mass shape, 0.28; microcalcification morphology, 0.36; and microcalcification distribution, 0.47. Lesion management was highly variable, with a kappa value for final assessment of 0.37. When we grouped assessments recommending immediate additional evaluation and biopsy (BI-RADS categories 0, 4, and 5 combined) versus follow-up (categories 1, 2, and 3 combined), five observers agreed on management for only 47 (55%) of 86 lesions. Intraobserver agreement on management (additional evaluation or biopsy versus follow-up) was seen in 47 (85%) of 55 interpretations, with a kappa value of 0.35-1.0 (mean, 0.60) for final assessment. Inter- and intraobserver variability in mammographic interpretation is substantial for both feature analysis and management. Continued development of methods to improve standardization in mammographic interpretation is needed.

The American College of Radiology mammography lexicon: an initial attempt to standardize terminology.

demicandnonacademic radiologists.Thesuggested terminology represents acombination offindings assessment aswellasstandardized language. Theorigins fortheterminology evolved fromastudythatusedxerography todefineafeatures checklist thatwasrelatedtotheprobability ofmalignancy [1].Byuseofthischecklist,containing manyofthetermsincluded intheBI-RADS lexi-con,thegeneralist’s performance wasbrought tothelevelofthespecialist withregard tointerpretation. Thisstudywaslaterrepeated withafilm-screen technique, andthefeatureschecklist wasmodified further [2].Thelatterstudydemon-stratedagaininsensitivity onspecificity of5%oventhevalueof85%attained intheformerstudy[1].Whenasubsetofdif-ficultcaseswasexamined, theenhancement insensitivity orspecificity was15%.Thus,theterminology anddefinitionswithintheBI-RADS lexicon servebothtoaidinseparatingbenignfrommalignant mammographic findings aswellastoestablish astandardized language foruseinmammographicinterpretation.

Breast imaging reporting and data system standardized mammography lexicon: observer variability in lesion description.

The American College of Radiology has recommended the Breast Imaging Reporting and Data System (BI-RADS) as a standardized scheme for describing mammographic lesions. The objective of this study was to measure inter- and intraobserver variabilities of radiologists' descriptions of mammographic lesions with the BI-RADS standardized lexicon. Sixty mammographic studies with abnormal findings were independently evaluated by five radiologists. Readers described each lesion by selecting a single term from the BI-RADS lexicon for each of eight morphologic categories: calcification distribution, number, and description; mass margin, shape, and density; associated findings; and special cases. Additionally, each reader assessed the significance of each lesion on a five-point scale. One observer read each case twice. Inter- and intraobserver variabilities for each description and interpretation category of the BI-RADS lexicon were determined with Cohen's kappa statistic. Radiologists' specific use of calcification descriptors was evaluated in detail. Substantial agreement was observed between readers for choosing terms to describe masses and calcifications (kappa value range, 0.50 +/- 0.02-0.77 +/- 0.03). Intraobserver agreement for these categories was similar (kappa value range, 0.57 +/- 0.07-0.84 +/- 0.09). Considerable inter- and intraobserver variabilities were noted for the "associated findings" and "special cases" categories (kappa value range, -0.02 +/- 0.14-0.38 +/- 0.12), a result that in part reflected the small number of cases to which these categories were assigned. Moderate interobserver variability and little intraobserver variability in the interpretation of lesion significance were noted when an assessment classification similar to that of BI-RADS was used. Use of terms to describe calcifications did not always conform to BI-RADS-defined levels of suspicion. BI-RADS is moderately successful in providing a standardized language for physicians to describe lesion morphology. Efforts to reevaluate specific terms and the diagnostic significance assigned to calcification descriptors may prove useful in maintaining the promise of improved quality with the BI-RADS standardized mammography lexicon.

The American College of Radiology's mammography lexicon: barking up the only tree.

The American College of Radiology's mammography lexicon: barking up the only tree.C J D'Orsi and D B KopansAudio Available | Share

The American College of Radiology's mammography lexicon: barking up the wrong tree?

Mammography reports are often wordy and inconclusive. To solve this problem, the American College of Radiology (ACR) created the Breast Imaging Reporting and Data System (BI-RADS) with a lexicon of specifically defined words, designed to be used, exclusive of any other terminology, to describe all significant breast imaging findings. The premise for developing BI-RADS was that strict verbal uniformity is a prerequisite for a national mammography data base and will also result in concise, directive reporting. Although this approach seems reasonable at first glance, BI-RADS, in my opinion, has several fundamental flaws.