Kaiser Score in Multiparametric Breast MRI: Prospective Validation and Comparison with BI-RADS for Predicting Malignancy

Najah Raham Rashid; Yusur Muhammad Said Al-Rawi; Yasameen Falah Aaber

doi:10.54133/ajms.v11i1.3010

Authors

Najah Raham Rashid Department of General Surgery, College of Medicine, Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq https://orcid.org/0009-0009-2471-6138
Yusur Muhammad Said Al-Rawi Department of General Surgery, College of Medicine, Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq https://orcid.org/0009-0007-2939-0646
Yasameen Falah Aaber Department of General Surgery, College of Medicine, Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq

DOI:

https://doi.org/10.54133/ajms.v11i1.3010

Keywords:

Breast malignancy, BI-RADS, Kaiser score, Lesion, MRI

Abstract

Background: Early detection is essential to determine breast cancer prognosis. The reliability of BI-RADS diagnoses varies, and the level of agreement between radiologists who read the same test is moderate at best. Kaiser Score offers a framework for evaluating breast lesions. Objective: To evaluate the breast cancer diagnostic landscape in Iraq by analyzing the Kaiser Score compared to the combination with BI-RADS. Methods: A prospective, cross-sectional diagnostic accuracy study was conducted at Private Radiology Center in Baghdad during December 2023 to December 2025. The study comprised 52 female patients, with a total of 90 suspected breast lesions, who needed multiparametric MRI to assess a recent abnormality found through ultrasonography or mammography, or to diagnose breast complaints with available Kaiser Score parameters, and underwent histopathological examination for confirmation of diagnosis. Results: Kaiser score was significantly higher in malignant than in benign lesions (8.62 vs. 3.23, p<0.001). Regarding BI-RADS, the highest proportion of malignant lesions was seen significantly among lesions classified as BI-RADS 5 (95%, p<0.001). A Kaiser score >6 is a predictor for malignant breast lesions. It was 94.3% sensitive, 98.2% specific, and 96.7% accurate. Sensitivity for lesions with a score of 4 or 5 BI-RADS was 97.1%, specificity was 67.3%, and accuracy was 78.9%. Conclusions: With KS, we can achieve better overall accuracy and more specificity. On its own, BI‑RADS is quite sensitive, but it lacks specificity. Implementing a combination of the two could lead to better decisions and fewer needless biopsies.

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