Imrana Masroor, Shaista Afzal, Uffan Zafar, Hina Pathan.
Reporting breast ultrasound: challenges in meeting imaging standards in the third world.
Pak J Radiol Jan ;33(1):05-8.

INTRODUCTION: In the last two decades, early detection of breast cancer using mammographic techniques and reliance of high-quality images has significantly reduced mortality from breast cancer. 1 Although improvement in image quality has largely revolved around the modality of breast imaging. Ultrasonography (US) plays a critical role in the diagnostic evaluation of palpable breast lesions or those flagged up by screening programmes. This study highlights the results from two cycles of an audit comparing American College of Radiology standards for breast ultrasound imaging, performed at a tertiary care centre in third world country. METHOD: Two rounds of audit were carried out. After the results of first audit, action plan was implemented after discussion in departmental meeting. In first round a prospective analysis of a consecutive sample of 100 images and reports of breast ultrasound performed at the Radiology Department of Aga khan University Hospital, Karachi, Pakistan was performed, in month of June 2021. Six months after the first cycle, a second audit of another prospective 100 breast ultrasound images and reports was reviewed in month of December 2021 and second action plan was implemented and the results were compared for future directions. RESULTS: The results of first audit revealed poor compliance in reporting certain parameter as part of the formal report, these included margins, texture, and shape of the lesion. There was significant improvement in all parameters in second cycle. We were able to maintain a reporting rate of 100% in all three of the parameters which was achieved in the 1st round of auditing. CONCLUSION: The compliance increased significantly by creating awareness and discussions in departmental meeting. The aim of those meetings were to highlight the current lack in practice standards to the faculty. This acted as reinforcement to their clinical practices and knowledge of reporting a breast ultrasound.

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