BI-RADS 6th Edition Updates and Challenging Cases (2024)-T8-CBR04-2024

Video Transcription

Video Summary

The video discusses updates and enhancements made in the 6th edition of the BI-RADS Atlas, focusing on mammography, ultrasound, and MRI for breast imaging. The 6th edition emphasizes modality-neutral and structured clinical indications to streamline vendor templates, structured reporting, and correct coding and billing. The Atlas has undergone extensive review by subcommittees, outside experts, and is subject to final approval before publication.<br /><br />Key changes include the removal of ambiguous terms like "developing asymmetry" and the introduction of new classifications for mass descriptors and calcifications. Tissue classifications such as breast density have been adjusted to better represent mammographic accuracy and cancer risk. The term "lobulated" has been reinstated as a mass descriptor to improve clarity. Changes in lymph node assessment now allow for clearer management of normal and abnormal nodes regardless of modality.<br /><br />In breast MRI, the focus classification has been removed due to inconsistency and most findings can be described as mass or focal non-mass enhancement. New protocols for T2 signal intensity and lymph node characterization have been introduced. The BI-RADS 3 category now has more data supporting its use but is cautioned against extensive use due to variability in malignancy rates.<br /><br />The audit section now covers modality neutrality and redefines screening vs. diagnostic exams, promoting consistent benchmarking. High-risk lesions have been reclassified, and optional audits for BI-RADS 3 findings and MRI-detected extensive disease have been introduced to gather meaningful data.<br /><br />Overall, the updates aim to provide more precise, evidence-based guidelines and expand understanding of breast imaging across different modalities, enhancing consistency and improving patient outcomes.

Keywords

BI-RADS Atlas

breast imaging

mammography

ultrasound

MRI

mass descriptors

breast density

lymph node assessment

modality-neutral

structured reporting