BI-RADS Fifth Edition — A Pictorial Review

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 14, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 1.25
Patient Care: 1.25
Patient Interactions and Management: 1.25

Mammography: 1.25
Procedures: 1.25
Anatomy, Physiology, and Pathology: 1.25

Magnetic Resonance Imaging: 0.50
Procedures: 0.50
Body: 0.50

Registered Radiologist Assistant: 1.75
Safety: 1.75
Patient Safety, Radiation Protection, and Equipment Operation: 1.75

Outline

1. Introduction
2. Brief History of BI-RADS
3. Overview of BI-RADS Fifth Edition: Mammography Revisions
   1. Density
   2. Masses
   3. Calcifications
   4. Architectural Distortion
   5. Asymmetries
   6. Special Cases
   7. Associated Features
   8. Location of Lesion
4. Overview of BI-RADS Fifth Edition: US Revisions
   1. Tissue Composition
   2. Masses
   3. Calcifications
   4. Associated Features
   5. Special Cases
5. Overview of BI-RADS Fifth Edition: MR Imaging Revisions
   1. New Sections
   2. Focus
   3. Masses
   4. Nonmass Enhancement
   5. Associated Findings
   6. Location of Lesion
   7. Kinetic Curve Assessment
   8. MR Imaging: Implants
6. Assessment Categories
7. Guidance Subsection
8. Improvements
9. Conclusion

Objectives

Upon completion of this course, students will:

1. list attributes that allow radiologists to communicate breast findings to referring physicians clearly and succinctly
2. state what year the BI-RADS fifth edition lexicon was released
3. recall how many years the BI-RADS fourth edition lexicon was in place
4. describe goals of the first BI-RADS lexicon
5. list all years in which a BI-RADS lexicon has been revised
6. state the types of breast tissue
7. list the mass shapes in the BI-RADS fifth edition: mammography revision section
8. list the categories for determining breast density in the BI-RADS fifth edition: mammography revision section
9. state the calcification categories in the BI-RADS fifth edition: mammography revision section
10. recall the calcification categories in the BI-RADS fifth edition: mammography revision section
11. state the increased risk for malignancy in amorphous calcifications
12. explain terminology relative to breast asymmetries
13. define developing asymmetry
14. state how the term associated features is utilized to characterize masses, calcifications, and asymmetries
15. name the new subsection addition to the breast ultrasound section of the BI-RADS fifth edition
16. recall changes to the breast ultrasound section in the fifth edition of the BI-RADS lexicon
17. list the terms describing tissue composition in the ultrasound section of the fifth edition, BI-RADS revisions
18. note the simplification of posterior acoustic features to posterior features
19. describe the difference between the category “vascularity” and the term “vascularity” in the ultrasound section of the BI-RADS fifth edition
20. list the descriptors in the new section “elasticity assessment” of the ultrasound revisions
21. tell how many sections for “associated findings” there are in the MR revisions of the BI-RADS fifth edition
22. state how a mass is defined
23. list mass descriptors for the MR section of the BI-RADS fifth edition
24. name the two descriptor categories for margins in the MR section of the BI-RADS fifth edition
25. state the non-mass enhancement term that has been eliminated in the MR section of the BI-RADS fifth edition
26. describe the initial phase of the kinetic curve
27. list the terms that describe the changes in the kinetic curve
28. state the reasons for breast MR imaging of implants
29. state the year the U.S. FDA halted the use of silicone breast implants for cosmesis
30. recall the modality that does not use categories 4A,4B, or 4C for assessment