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Agreement of mammographic measures of volumetric breast density to MRI.

Wang J, Azziz A, Fan B, Malkov S, Klifa C, Newitt D, Yitta S, Hylton N, Kerlikowske K, Shepherd JA - PLoS ONE (2013)

Bottom Line: Women were selected from the UCSF Medical Center screening population that had received both a screening MRI and digital mammogram within one year of each other, had Breast Imaging Reporting and Data System (BI-RADS) assessments of normal or benign finding, and no history of breast cancer or surgery.The kappa statistics for all percent density measures were highest in the comparisons of the SXA and MRI results.Automated volumetric fibroglandular tissue measures from screening digital mammograms were in substantial agreement with MRI and if associated with breast cancer could be used in clinical practice to enhance risk assessment and prevention.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States of America.

ABSTRACT

Background: Clinical scores of mammographic breast density are highly subjective. Automated technologies for mammography exist to quantify breast density objectively, but the technique that most accurately measures the quantity of breast fibroglandular tissue is not known.

Purpose: To compare the agreement of three automated mammographic techniques for measuring volumetric breast density with a quantitative volumetric MRI-based technique in a screening population.

Materials and methods: Women were selected from the UCSF Medical Center screening population that had received both a screening MRI and digital mammogram within one year of each other, had Breast Imaging Reporting and Data System (BI-RADS) assessments of normal or benign finding, and no history of breast cancer or surgery. Agreement was assessed of three mammographic techniques (Single-energy X-ray Absorptiometry [SXA], Quantra, and Volpara) with MRI for percent fibroglandular tissue volume, absolute fibroglandular tissue volume, and total breast volume.

Results: Among 99 women, the automated mammographic density techniques were correlated with MRI measures with R(2) values ranging from 0.40 (log fibroglandular volume) to 0.91 (total breast volume). Substantial agreement measured by kappa statistic was found between all percent fibroglandular tissue measures (0.72 to 0.63), but only moderate agreement for log fibroglandular volumes. The kappa statistics for all percent density measures were highest in the comparisons of the SXA and MRI results. The largest error source between MRI and the mammography techniques was found to be differences in measures of total breast volume.

Conclusion: Automated volumetric fibroglandular tissue measures from screening digital mammograms were in substantial agreement with MRI and if associated with breast cancer could be used in clinical practice to enhance risk assessment and prevention.

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Related in: MedlinePlus

Six comparisons of the LCC mammograms to their respective left central breast axial-slice MR images on five different women (c and d are the same woman).The white line connecting points in the MR images define the total breast volume. The MRI fibroglandular volume is shown delineated with white lines without points. Solid data points 4a–4f in Figure 1 correspond to the image labels a–f. Compared to the mammographically-derived SXA values, a) MRI percent density is higher, b) MRI percent density is lower, c) MRI breast volume is higher, d) of the same woman as c (this mammogram not part of analyses, only here and measures plotted in Figure 1 to illustrate one reason for discrepancy between methods' results), MRI breast volume is better segmented due to the breast being extended more into the mammographic image field, e) MRI breast volume is lower, f) all MRI measures of density and volume were in substantial agreement.
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pone-0081653-g004: Six comparisons of the LCC mammograms to their respective left central breast axial-slice MR images on five different women (c and d are the same woman).The white line connecting points in the MR images define the total breast volume. The MRI fibroglandular volume is shown delineated with white lines without points. Solid data points 4a–4f in Figure 1 correspond to the image labels a–f. Compared to the mammographically-derived SXA values, a) MRI percent density is higher, b) MRI percent density is lower, c) MRI breast volume is higher, d) of the same woman as c (this mammogram not part of analyses, only here and measures plotted in Figure 1 to illustrate one reason for discrepancy between methods' results), MRI breast volume is better segmented due to the breast being extended more into the mammographic image field, e) MRI breast volume is lower, f) all MRI measures of density and volume were in substantial agreement.

Mentions: Solid points correspond to example images in Figure 4.


Agreement of mammographic measures of volumetric breast density to MRI.

Wang J, Azziz A, Fan B, Malkov S, Klifa C, Newitt D, Yitta S, Hylton N, Kerlikowske K, Shepherd JA - PLoS ONE (2013)

Six comparisons of the LCC mammograms to their respective left central breast axial-slice MR images on five different women (c and d are the same woman).The white line connecting points in the MR images define the total breast volume. The MRI fibroglandular volume is shown delineated with white lines without points. Solid data points 4a–4f in Figure 1 correspond to the image labels a–f. Compared to the mammographically-derived SXA values, a) MRI percent density is higher, b) MRI percent density is lower, c) MRI breast volume is higher, d) of the same woman as c (this mammogram not part of analyses, only here and measures plotted in Figure 1 to illustrate one reason for discrepancy between methods' results), MRI breast volume is better segmented due to the breast being extended more into the mammographic image field, e) MRI breast volume is lower, f) all MRI measures of density and volume were in substantial agreement.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3852736&req=5

pone-0081653-g004: Six comparisons of the LCC mammograms to their respective left central breast axial-slice MR images on five different women (c and d are the same woman).The white line connecting points in the MR images define the total breast volume. The MRI fibroglandular volume is shown delineated with white lines without points. Solid data points 4a–4f in Figure 1 correspond to the image labels a–f. Compared to the mammographically-derived SXA values, a) MRI percent density is higher, b) MRI percent density is lower, c) MRI breast volume is higher, d) of the same woman as c (this mammogram not part of analyses, only here and measures plotted in Figure 1 to illustrate one reason for discrepancy between methods' results), MRI breast volume is better segmented due to the breast being extended more into the mammographic image field, e) MRI breast volume is lower, f) all MRI measures of density and volume were in substantial agreement.
Mentions: Solid points correspond to example images in Figure 4.

Bottom Line: Women were selected from the UCSF Medical Center screening population that had received both a screening MRI and digital mammogram within one year of each other, had Breast Imaging Reporting and Data System (BI-RADS) assessments of normal or benign finding, and no history of breast cancer or surgery.The kappa statistics for all percent density measures were highest in the comparisons of the SXA and MRI results.Automated volumetric fibroglandular tissue measures from screening digital mammograms were in substantial agreement with MRI and if associated with breast cancer could be used in clinical practice to enhance risk assessment and prevention.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States of America.

ABSTRACT

Background: Clinical scores of mammographic breast density are highly subjective. Automated technologies for mammography exist to quantify breast density objectively, but the technique that most accurately measures the quantity of breast fibroglandular tissue is not known.

Purpose: To compare the agreement of three automated mammographic techniques for measuring volumetric breast density with a quantitative volumetric MRI-based technique in a screening population.

Materials and methods: Women were selected from the UCSF Medical Center screening population that had received both a screening MRI and digital mammogram within one year of each other, had Breast Imaging Reporting and Data System (BI-RADS) assessments of normal or benign finding, and no history of breast cancer or surgery. Agreement was assessed of three mammographic techniques (Single-energy X-ray Absorptiometry [SXA], Quantra, and Volpara) with MRI for percent fibroglandular tissue volume, absolute fibroglandular tissue volume, and total breast volume.

Results: Among 99 women, the automated mammographic density techniques were correlated with MRI measures with R(2) values ranging from 0.40 (log fibroglandular volume) to 0.91 (total breast volume). Substantial agreement measured by kappa statistic was found between all percent fibroglandular tissue measures (0.72 to 0.63), but only moderate agreement for log fibroglandular volumes. The kappa statistics for all percent density measures were highest in the comparisons of the SXA and MRI results. The largest error source between MRI and the mammography techniques was found to be differences in measures of total breast volume.

Conclusion: Automated volumetric fibroglandular tissue measures from screening digital mammograms were in substantial agreement with MRI and if associated with breast cancer could be used in clinical practice to enhance risk assessment and prevention.

Show MeSH
Related in: MedlinePlus