title: Semiautomatic estimation of breast density with DM-Scan software.
abstract: OBJECTIVE
  To evaluate the reproducibility of the calculation of breast density with DM-Scan software, which is based on the semiautomatic segmentation of fibroglandular tissue, and to compare it with the reproducibility of estimation by visual inspection.
  
  
  METHODS
  The study included 655 direct digital mammograms acquired using craniocaudal projections. Three experienced radiologists analyzed the density of the mammograms using DM-Scan, and the inter- and intra-observer agreement between pairs of radiologists for the Boyd and BI-RADS® scales were calculated using the intraclass correlation coefficient. The Kappa index was used to compare the inter- and intra-observer agreements with those obtained previously for visual inspection in the same set of images.
  
  
  RESULTS
  For visual inspection, the mean interobserver agreement was 0,876 (95% CI: 0,873-0,879) on the Boyd scale and 0,823 (95% CI: 0,818-0,829) on the BI-RADS® scale. The mean intraobserver agreement was 0,813 (95% CI: 0,796-0,829) on the Boyd scale and 0,770 (95% CI: 0,742-0,797) on the BI-RADS® scale. For DM-Scan, the mean inter- and intra-observer agreement was 0,92, considerably higher than the agreement for visual inspection.
  
  
  CONCLUSIONS
  The semiautomatic calculation of breast density using DM-Scan software is more reliable and reproducible than visual estimation and reduces the subjectivity and variability in determining breast density.
authors.affiliation: Programa de Cribado de Cáncer de Mama de la Comunidad Valenciana, Unidad de Alzira, Alzira, Valencia, España. Electronic address: martinez_inm@gva.es.
authors.forename: I
authors.initials: I
authors.lastname: Martínez Gómez
authors.affiliation: Programa de Cribado de Cáncer de Mama de la Comunidad Valenciana, Unidad de Valencia, Valencia, España.
authors.forename: M
authors.initials: M
authors.lastname: Casals El Busto
authors.affiliation: Instituto Tecnológico de Informática, Universidad Politécnica de Valencia, Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: Antón Guirao
authors.affiliation: Programa de Cribado de Cáncer de Mama, Centro Superior de Investigación Salud Pública (CSISP), Valencia, España.
authors.forename: F
authors.initials: F
authors.lastname: Ruiz Perales
authors.affiliation: Instituto Tecnológico de Informática, Universidad Politécnica de Valencia, Valencia, España.
authors.forename: R
authors.initials: R
authors.lastname: Llobet Azpitarte
mesh_terms: D000368:Aged; D000071060:Breast Density; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D012984:Software
keywords: Breast cancer; Breast density; Computer-assisted diagnosis; Cáncer de mama; Densidad mamaria; Diagnóstico asistido por ordenador; Digital processing of mammograms; Interobserver variability; Intraobserver variability; Mammography; Mamografía; Procesamiento digital de mamografías; Variabilidad interobservador; Variabilidad intraobservador