title: Mammographic density estimation: comparison among BI-RADS categories, a semi-automated software and a fully automated one.
abstract: Although breast density is considered a strong predictor of breast cancer risk, its quantitative assessment is difficult. The aim of this study is to demonstrate that breast density assessment with a fully automated software is feasible and correlates with the semi-automated evaluation and the quantitative BI-RADS standards. A data set of 160 mammograms was evaluated by three blinded radiologists. Intra-observer (reader 1: k=0.71; reader 2: k=0.76; reader 3: k=0.62) and inter-observer (reader 1 vs reader 2: k=0.72; reader 2 vs reader 3: k=0.80; reader 3 vs reader 1: k=0.72) variability for the semi-automated software were good on a four-grade scale (D1/D2/D3/D4) and correlated with BI-RADS evaluation made by other two blinded radiologists (r=0.65, p<0.01). Inter-observer (reader 1 vs reader 2: k=0.85; reader 2 vs reader 3: k=0.91; reader 3 vs reader 1: k=0.85) variability for the semi-automated software was very good on a two-grade scale (D1-D2/D3-D4). The use of the fully automated software eliminated intra- and inter-observer differences, correlated with BI-RADS categories (r=0.62, p<0.01) and can replace the semi-automated one (Bland-Altman statistics). Our study demonstrates that automated estimation of breast density is feasible and eliminates subjectivity. Furthermore both the semi-automated and the fully automated density estimation are more accurate than BI-RADS quantitative evaluation and could also be used in the daily clinical practice.
authors.affiliation: Cattedra di Radiologia R, DICMI, Università di Genova, Genova, Italy. Alberto.Tagliafico@unige.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Tagliafico
authors.forename: Giulio
authors.initials: G
authors.lastname: Tagliafico
authors.forename: Simona
authors.initials: S
authors.lastname: Tosto
authors.forename: Fabio
authors.initials: F
authors.lastname: Chiesa
authors.forename: Carlo
authors.initials: C
authors.lastname: Martinoli
authors.forename: Lorenzo E
authors.initials: LE
authors.lastname: Derchi
authors.forename: Massimo
authors.initials: M
authors.lastname: Calabrese
mesh_terms: D000465:Algorithms; D001943:Breast Neoplasms / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008327:Mammography / Q000145:classification / Q000592:standards*; D015588:Observer Variation; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000592:standards*; D015203:Reproducibility of Results; D012984:Software