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Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
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Subjective Versus Quantitative Methods of Assessing Breast Density.

Wijdan Alomaim1, Desiree O'Leary2, John Ryan3

  • 1Radiography & Medical Imaging, Fatima College of Health Sciences, Abu Dhabi, UAE.

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|May 28, 2020
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Summary
This summary is machine-generated.

Assessing mammographic breast density (MBD) showed international variability. Subjective assessment is fastest, followed by VOLPARA, highlighting the need for consistent, efficient MBD evaluation methods in clinical settings.

Keywords:
American College of Radiology Breast Imaging Reporting and Data SystemBI-RADSImageJVOLPARAautomated volumetric breast density measurementbreast densitybreast imagingmammographic breast densityquantitative density assessment

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Area of Science:

  • Radiology
  • Medical Imaging
  • Biostatistics

Background:

  • Mammographic breast density (MBD) assessment is crucial for breast cancer risk stratification.
  • Current MBD assessment methods exhibit variability, impacting consistency and efficiency.
  • International differences in MBD interpretation necessitate standardized evaluation techniques.

Purpose of the Study:

  • To compare subjective, quantitative, semi-subjective, and semi-quantitative methods for assessing mammographic breast density.
  • To evaluate the agreement between different MBD assessment techniques and international radiologist interpretations.
  • To identify a consistent, simple, and time-efficient method for MBD assessment.

Main Methods:

  • Subjective MBD ratings were obtained from 49 radiologists across the UK and USA for 250 anonymized mammographic cases.
  • Quantitative MBD was calculated using VOLPARA, Hand Delineation (HD), and ImageJ (IJ) on the same cases (n=122 for VOLPARA).
  • Agreement levels between methods were analyzed using weighted kappa (κw) statistics.

Main Results:

  • Agreement between UK/USA radiologists and VOLPARA ranged from moderate (κw = 0.589) to substantial (κw = 0.639).
  • Substantial agreement was observed between radiologists and VOLPARA with ImageJ (κw = 0.752-0.768).
  • Agreement with Hand Delineation varied from moderate to substantial (κw = 0.597-0.680).

Conclusions:

  • Significant international variability exists in subjective and objective MBD assessment methods.
  • Subjective assessment is the quickest method, followed by VOLPARA, suitable for busy clinical settings.
  • A simplified two-scale system may improve agreement and minimize country-specific biases in MBD assessment.