BR vs SPI: ARDMS Exam Comparison
This page compares the ARDMS Breast (BR) and Sonography Principles & Instrumentation (SPI) exams side by side. Both are ARDMS-administered specialty examinations, but they differ in clinical scope, content focus, career setting, and 2025 pass-rate data.
BR vs SPI: Exam Comparison
| Factor | Breast (BR) | Sonography Principles & Instrumentation (SPI) |
|---|---|---|
| Credential earned | RDMS | RDMS/RVT prerequisite |
| Question count | 170 | 110 |
| Exam duration | 3 hours | 2 hours |
| 2025 first-time pass rate | 77% | 74% |
About the Breast (BR) Exam
The ARDMS Breast (BR) specialty exam covers breast anatomy, the ACR BI-RADS lexicon, benign and malignant pathology patterns, image-guided procedures, and supplemental screening. The BI-RADS framework is the organizational backbone of the entire exam and must be understood at a category-by-category level.
About the Sonography Principles & Instrumentation (SPI) Exam
The ARDMS Sonography Principles and Instrumentation (SPI) exam is the physics prerequisite required before earning any ARDMS specialty credential. It tests sound wave physics, transducer construction, image formation, ultrasound artifacts, Doppler principles, quality assurance, bioeffects, and ALARA safety principles. Unlike specialty exams, the SPI rewards an academic rather than clinical approach.
Which Exam Should You Take First?
The right choice depends on your clinical background, your current employer's needs, and your long-term career goals. Sonographers with strong clinical experience in breast imaging should consider the BR exam first, as applied clinical knowledge transfers directly to board performance. Similarly, those working predominantly in sonography principles & instrumentation settings will find the SPI exam more immediately supported by their daily practice.
Both credentials are valuable additions to a multi-specialty credential portfolio. The 2025 first-time pass rates — 77% for BR and 74% for SPI — underscore the importance of structured, domain-aligned preparation for whichever exam you choose first.
Dig Deeper Into Each Specialty
- Breast (BR) exam prep · BR practice questions
- Sonography Principles & Instrumentation (SPI) exam prep · SPI practice questions
Related Comparisons
See all ARDMS specialty comparisons → | Practice-question hub →