Diagnostic performance of the Kaiser score for characterizing lesions on breast MRI with comparison to a multiparametric classification system

Abstract

To determine the diagnostic performance of the Kaiser score and to compare it with the BI-RADS-based multiparametric classification system (MCS). Method: Two breast radiologists, blinded to the clinical and pathological information, separately evaluated a database of 499 consecutive patients with structural 3.0 T breast MRI and 697 histopathologically verified lesions. The Kaiser scores and corresponding MCS categories were recorded. The sensitivity and specificity of the Kaiser score and the MCS categories to differentiate benign from malignant lesions were calculated. The interobserver reproducibility and receiver operating characteristic (ROC) parameters were analysed. Results: The sensitivity and specificity of the MCS were 100 % and 12 %, respectively, and those of the Kaiser score were 98.5 % and 34.8 % for reader 1 and 98.7 % and 47.5 % for reader 2. The area under the ROC-curve was 85.9 and 87.6 for readers 1 and 2. The interobserver intraclass correlation coefficient was excellent at 0.882. Reader 1 upgraded six lesions from BI-RADS 3 to a Kaiser score of >4, and reader 2 upgraded seven lesions. When applying the Kaiser score to 158 benign lesions readers 1 and 2 would have reduced the biopsy rate by 22.8 % and 35.4 %, respectively. Conclusions: The Kaiser score showed high diagnostic accuracy with excellent interobserver reproducibility. The MCS had perfect sensitivity but low specificity. Although the Kaiser score had slightly lower sensitivity, its specificity was 3-4 times greater than that of the MCS. Thus, the Kaiser score has the potential to considerably reduce the biopsy rate for true negative lesions.

A Comparative Assessment of MR BI-RADS 4 Breast Lesions With Kaiser Score and Apparent Diffusion Coefficient Value

“…The data were analyzed using SPSS 26.0 (IBM) and MedCalc 19.8 (MedCalc Software). The intraclass correlation coefficient (ICC) ( 26 , 27 ) was used to analyze interobserver consistency. In this study, the quantitative data that did not conform to normal distribution were expressed in median and interquartile range (IQR) and were compared by using the Mann–Whitney U test.…”

How much can abbreviated protocols for breast MRI increase patient throughput? a multi-centric evaluation

“…Until such data are available, it may be safe to assume that the potential cost reduction by shortening the image data acquisition part of the breast MRI examination may be at least partly counteracted by an increased need for additional imaging such as second-look ultrasound or image-guided biopsies. At a high level of evidence, this is supported by publications demonstrating that the combination of multiple imaging parameters derived from full dynamic protocols provides independent and incremental diagnostic information for improved lesion classification [29][30][31][32][33][34][35].…”

A simplified scoring protocol to improve diagnostic accuracy with the breast imaging reporting and data system in breast magnetic resonance imaging

“…This classification tree includes five major diagnostic criteria: root sign, dynamic enhancement curve type, margins, internal enhancement pattern, and edema. Since its introduction in 2013, the Kaiser score has been reported to have high diagnostic accuracy for the differential diagnosis of benign and malignant lesions in a variety of selected patient populations (36)(37)(38)(39)(40). However, the Kaiser score does not include quantitative MRI techniques, such as DWI or quantitative DCE, and it is not associated with the BI-RADS lexicon.…”