BI-RADS for sonography: positive and negative predictive values of sonographic features

AJR Am J Roentgenol. 2005 Apr;184(4):1260-5. doi: 10.2214/ajr.184.4.01841260.


Objective: The purpose of this study was to assess the positive predictive value (PPV) and negative predictive value (NPV) of features described in the new sonographic BI-RADS lexicon for evaluating solid masses with known histologic diagnoses.

Materials and methods: Sonograms of 403 solid lesions were analyzed by one of three dedicated breast radiologists. Each lesion was described using features from the sonographic BI-RADS lexicon. Lesion description and biopsy results were correlated. PPV and NPV were calculated.

Results: Histologic results showed that 141 (35%) of 403 masses were malignant. Sonographic BI-RADS descriptors showing high predictive value for malignancy include spiculated margin (86%, 19/22), irregular shape (62%, 102/164), and nonparallel orientation (69%, 75/109). Sonographic BI-RADS descriptors highly predictive of benign lesions include circumscribed margin (90%, 160/178), parallel orientation (78%, 228/294), and oval shape (84%, 200/237). For the sonographic BI-RADS features of mass margin, shape, orientation, lesion boundary, echo pattern, and posterior acoustic features, descriptors chosen were significantly (p < 0.001) different for malignant and benign masses.

Conclusion: Descriptors from the new sonographic BI-RADS lexicon can be useful in differentiating benign from malignant solid masses.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology
  • Chi-Square Distribution
  • Diagnosis, Differential
  • Female
  • Humans
  • Mammography
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Ultrasonography, Mammary