The reliability of measuring physical characteristics of spiculated masses on mammography

The goal of this study was to assess the reliability of measurements of the physical characteristics of spiculated masses on mammography. The images used in this study were obtained from the Digital Database for Screening Mammography. Two experienced radiologists measured the properties of 21 images of spiculated masses. The length and width of all spicules and the major axis of the mass were measured. In addition, the observers counted the total number of spicules. Interobserver and intraobserver variability were evaluated using a hypothesis test for equivalence, the intraclass correlation coefficient (ICC) and Bland-Altman statistics. For an equivalence level of 30% of the mean of the senior radiologist's measurement, equivalence was achieved for the measurements of average spicule length (p<0.01), average spicule width (p=0.03), the length of the major axis (p<0.01) and for the count of the number of spicules (p<0.01). Similarly, with the ICC analysis technique "excellent" inter-rater agreement was observed for the measurements of average spicule length (ICC=0.770), the length of the major axis (ICC=0.801) and for the count of the number of spicules (ICC=0.780). "Fair to good" agreement was observed for the average spicule width (ICC=0.561). Equivalence was also demonstrated for intraobserver measurements. Physical properties of spiculated masses can be measured reliably on mammography. The interobserver and intraobserver variability for this task is comparable with that reported for other measurements made on medical images.