Mammographic density estimation with automated volumetric breast density measurement.
OBJECTIVE
To compare automated volumetric breast density measurement (VBDM) with radiologists' evaluations based on the Breast Imaging Reporting and Data System (BI-RADS), and to identify the factors associated with technical failure of VBDM.


METHODS
In this study, 1129 women aged 19-82 years who underwent mammography from December 2011 to January 2012 were included. Breast density evaluations by radiologists based on BI-RADS and by VBDM (Volpara Version 1.5.1) were compared. The agreement in interpreting breast density between radiologists and VBDM was determined based on four density grades (D1, D2, D3, and D4) and a binary classification of fatty (D1-2) vs. dense (D3-4) breast using kappa statistics. The association between technical failure of VBDM and patient age, total breast volume, fibroglandular tissue volume, history of partial mastectomy, the frequency of mass > 3 cm, and breast density was analyzed.


RESULTS
The agreement between breast density evaluations by radiologists and VBDM was fair (k value = 0.26) when the four density grades (D1/D2/D3/D4) were used and moderate (k value = 0.47) for the binary classification (D1-2/D3-4). Twenty-seven women (2.4%) showed failure of VBDM. Small total breast volume, history of partial mastectomy, and high breast density were significantly associated with technical failure of VBDM (p = 0.001 to 0.015).


CONCLUSIONS
There is fair or moderate agreement in breast density evaluation between radiologists and VBDM. Technical failure of VBDM may be related to small total breast volume, a history of partial mastectomy, and high breast density.
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752, Korea. ; Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju 690-767, Korea.
Su Yeon
SY
Ko
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752, Korea.
Eun-Kyung
EK
Kim
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752, Korea.
Min Jung
MJ
Kim
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752, Korea.
Hee Jung
HJ
Moon
D000328:Adult; D000368:Aged; D000071060:Breast Density; D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000002:abnormalities* / Q000601:surgery; D008327:Mammography; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D015588:Observer Variation; D011871:Radiology; D012189:Retrospective Studies; D055815:Young Adult
American College of Radiology Breast Imaging Reporting and Data System; Mammographic breast density; Volumetric breast density measurement