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Kaiser Score

Decision algorithm – basic free version

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Kaiser Score (SOR)

Result

Kaiser score not applicable.

Extremely low probability for the presence of a malignancy (<1%).

References:
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Bennani-Baiti et al. PLoS One. 2016 Aug 2;11(8):e0160346. doi: 10.1371/journal.pone.0160346
  • Baum et al. Eur Radiol. 2002 May;12(5):1087-92. doi: 10.1007/s00330-001-1213-1

Result

Kaiser score 1: Not suspicious. Imaging phenotype of a BI-RADS 2 finding. 

Further management depends on the clinical context.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 2: Not suspicious. Imaging phenotype of a BI-RADS 2 finding. 

Further management depends on the clinical context.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 3: Not suspicious. Imaging phenotype of a BI-RADS 2/3 finding. 
Further management depends on the clinical context.

Experts’ Tip: Check for corresponding suspicious microcalcifications on mammogram. If present >  DCIS/B3 possible! >  consider biopsy!

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 4: Benign imaging phenotype. 
Differentials: Adenosis (typically). Rarely: Papilloma. Fibroadenoma. Small cancer (<5mm). 

Management according to specific clinical context. 

Experts’ Tip: Intraductal location: Papilloma? > Biopsy
Small & solitary Kaiser score 4 lesion: Biopsy recommended, especially in BRCA1 mutation carriers.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 5: Suspicious. Malignancy possible. Imaging phenotype of a BI-RADS 4a lesion.
Differentials: DCIS > invasive cancer

Management according to specific clinical context.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 6: Suspicious. Malignancy possible. Imaging phenotype of a BI-RADS 4 lesion.

Management according to specific clinical context.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 7: Suspicious. Malignancy possible. Imaging phenotype of a BI-RADS 4 lesion.

Management according to specific clinical context.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 8: Highly suspicious. Imaging phenotype of a BI-RADS 5 lesion. 
Differentials: Aggressive Cancer. High grade. 
Rarely: Adenosis. Papilloma. Fibroadenoma.

Management according to specific clinical context. 
Experts’ Tip: Kaiser score 8 lesions stable at follow-up? > Most likely benign.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 9: Highly suspicious. Imaging phenotype of a BI-RADS 5 lesion. 
Differentials: Invasive cancer. High grade cancer.

Management according to specific clinical context.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3

Result

Kaiser score 10: Highly suspicious. Imaging phenotype of a BI-RADS 5 lesion. 
Differentials: Invasive cancer. High grade cancer. Lymphangiosis. Lymph node metastases.

Management according to specific clinical context.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Cheon et al. Radiology. 2018 Apr;287(1):68-75. doi: 10.1148/radiol.2017171157
  • Kaiser et al. Anticancer Res. 2017 Apr;37(4):1989-1995. doi: 10.21873/anticanres.11542
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3
  • Dietzel et al. 2010 Acta Radiol. 2010 Oct;51(8):885-94. doi: 10.3109/02841851.2010.504232

Result

Kaiser score 11: Highly suspicious. Imaging phenotype of a BI-RADS 5 lesion. 
Differentials: Invasive cancer. High grade cancer. Lymphangiosis. Lymph node metastases.

Management according to specific clinical context.

References:
  • Baltzer et al. 2022 Radiologie up2date 2022; 22(01): 33-49 doi: 10.1055/a-1561-9399
  • Meng et al. Front Oncol. 2021 Dec 2;11:779642. doi: 10.3389/fonc.2021.779642
  • Istomin et al. Eur J Radiol. 2021 May;138:109659. doi: 10.1016/j.ejrad.2021.109659
  • Grippo et al. Eur J Radiol. 2021 May;138:109630. doi: 10.1016/j.ejrad.2021.109630
  • Jajodia et al. Eur J Radiol. 2021 Jan;134:109413. doi: 10.1016/j.ejrad.2020.109413
  • Dietzel et al. Invest Radiol. 2021 May 1;56(5):274-282. doi: 10.1097/RLI.0000000000000739
  • Zhang et al. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):562-566. doi: 10.12122/j.issn.1673-4254.2020.04.18
  • Milos et al. Eur Radiol. 2020 Nov;30(11):6052-6061. doi: 10.1007/s00330-020-06945-z
  • Wengert et al. Eur Radiol. 2020 Mar;30(3):1451-1459. doi: 10.1007/s00330-019-06444-w
  • Dietzel und Baltzer Insights Imaging. 2018 Jun;9(3):325-335. doi: 10.1007/s13244-018-0611-8
  • Cheon et al. Radiology. 2018 Apr;287(1):68-75. doi: 10.1148/radiol.2017171157
  • Kaiser et al. Anticancer Res. 2017 Apr;37(4):1989-1995. doi: 10.21873/anticanres.11542
  • Woitek et al. Eur Radiol. 2017 Sep;27(9):3799-3809. doi: 10.1007/s00330-017-4755-6
  • Marino et al. Eur Radiol. 2016 Aug;26(8):2529-37. doi: 10.1007/s00330-015-4075-7
  • Baltzer et al. Eur Radiol. 2013 Aug;23(8):2051-60. doi: 10.1007/s00330-013-2804-3
  • Dietzel et al. 2010 Acta Radiol. 2010 Oct;51(8):885-94. doi: 10.3109/02841851.2010.504232

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