title: Quantra™ should be considered a tool for two-grade scale mammographic breast density classification.
abstract: OBJECTIVE
  To assess the agreement between Quantra™ (Hologic Inc., Bedford, MA) and Breast Imaging Reporting and Data Systems (BI-RADS(®)) and the performance of Quantra at reproducing BI-RADS mammographic breast density (MBD) assessment.
  
  
  METHODS
  MBD assessment was performed using Quantra and BI-RADS. BI-RADS assessment was performed in two phases (1314 and 292 cases, respectively). Kappa was used to assess the interreader agreement and the agreement between Quantra and BI-RADS, and receiver-operating characteristics analysis was used to assess the performance of Quantra at reproducing BI-RADS rating.
  
  
  RESULTS
  Agreement (weighted kappa) between BI-RADS and Quantra in Phase 1 was 0.75 [95% confidence interval (CI): 0.73-0.78] and 0.85 (95% CI: 0.80-0.90) on four- and two-grade scales, respectively. The corresponding agreement in Phase 2 was 0.79 (95% CI: 0.75-0.84) and 0.84 (95% CI: 0.79-0.87) using the majority report. In Phase 1, Quantra demonstrated 93.2% sensitivity and 86.1% specificity for BI-RADS on a two-grade scale (1-2 vs 3-4). In Phase 2, it demonstrated 91.3% sensitivity and 83.6% specificity on a two-grade scale.
  
  
  CONCLUSIONS
  Quantra is limited in reproducing BI-RADS rating on a four-grade scale; however, it highly reproduces BI-RADS assessment on a two-grade scale.
  
  
  CONCLUSIONS
  Quantra (v. 2.0) is a poor predictor of BI-RADS assessment on a four-grade scale, but well reproduces BI-RADS rating on a two-grade scale. Therefore, it should be considered a tool for two-grade scale MBD classification.
authors.affiliation: 1 Discipline of Medical Radiation Sciences in the Faculty of Health Sciences and the Brain and Mind Research Institute, The University of Sydney, Australia.|2 Department of Radiography and Radiology, University of Calabar, Calabar, Nigeria.
authors.forename: Ernest U
authors.initials: EU
authors.lastname: Ekpo
authors.affiliation: 1 Discipline of Medical Radiation Sciences in the Faculty of Health Sciences and the Brain and Mind Research Institute, The University of Sydney, Australia.
authors.forename: Mark F
authors.initials: MF
authors.lastname: McEntee
authors.affiliation: 1 Discipline of Medical Radiation Sciences in the Faculty of Health Sciences and the Brain and Mind Research Institute, The University of Sydney, Australia.|3 Sydney Breast Clinic, Sydney, NSW, Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Rickard
authors.affiliation: 1 Discipline of Medical Radiation Sciences in the Faculty of Health Sciences and the Brain and Mind Research Institute, The University of Sydney, Australia.
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Brennan
authors.affiliation: 3 Sydney Breast Clinic, Sydney, NSW, Australia.
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Kunduri
authors.affiliation: 1 Discipline of Medical Radiation Sciences in the Faculty of Health Sciences and the Brain and Mind Research Institute, The University of Sydney, Australia.
authors.forename: Delgermaa
authors.initials: D
authors.lastname: Demchig
authors.affiliation: 1 Discipline of Medical Radiation Sciences in the Faculty of Health Sciences and the Brain and Mind Research Institute, The University of Sydney, Australia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Mello-Thoms
mesh_terms: D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D009929:Organ Size; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D012680:Sensitivity and Specificity