title: Automated Breast Density Computation in Digital Mammography and Digital Breast Tomosynthesis: Influence on Mean Glandular Dose and BIRADS Density Categorization.
abstract: The study aimed to compare the breast density estimates from two algorithms on full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and to analyze the clinical implications.
  
  
  
  We selected 561 FFDM and DBT examinations from patients without breast pathologies. Two versions of a commercial software (Quantra 2D and Quantra 3D) calculated the volumetric breast density automatically in FFDM and DBT, respectively. Other parameters such as area breast density and total breast volume were evaluated. We compared the results from both algorithms using the Mann-Whitney U non-parametric test and the Spearman's rank coefficient for data correlation analysis. Mean glandular dose (MGD) was calculated following the methodology proposed by Dance et al.
  
  
  
  Measurements with both algorithms are well correlated (r ≥ 0.77). However, there are statistically significant differences between the medians (P < 0.05) of most parameters. The volumetric and area breast density median values from FFDM are, respectively, 8% and 77% higher than DBT estimations. Both algorithms classify 35% and 55% of breasts into BIRADS (Breast Imaging-Reporting and Data System) b and c categories, respectively. There are no significant differences between the MGD calculated using the breast density from each algorithm. DBT delivers higher MGD than FFDM, with a lower difference (5%) for breasts in the BIRADS d category. MGD is, on average, 6% higher than values obtained with the breast glandularity proposed by Dance et al.
  
  
  
  Breast density measurements from both algorithms lead to equivalent BIRADS classification and MGD values, hence showing no difference in clinical outcomes. The median MGD values of FFDM and DBT examinations are similar for dense breasts (BIRADS d category).
authors.affiliation: Medical Physics Group, Radiology Department, Medical School, Complutense University of Madrid, Pza. Ramón y Cajal, s/n, 28040 Madrid, Spain. Electronic address: m.castillo.g@ucm.es.
authors.forename: Maria
authors.initials: M
authors.lastname: Castillo-García
authors.affiliation: Medical Physics Group, Radiology Department, Medical School, Complutense University of Madrid, Pza. Ramón y Cajal, s/n, 28040 Madrid, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Chevalier
authors.affiliation: Radiological Protection Unit, Hospital Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Julia
authors.initials: J
authors.lastname: Garayoa
authors.affiliation: Radiology Department, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rodriguez-Ruiz
authors.affiliation: Medical Physics Group, Radiology Department, Medical School, Complutense University of Madrid, Pza. Ramón y Cajal, s/n, 28040 Madrid, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: García-Pinto
authors.affiliation: Radiological Protection Unit, Hospital Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Valverde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D011873:Radiology Information Systems; D015203:Reproducibility of Results
keywords: BIRADS categorization; Breast density; digital breast tomosynthesis; digital mammography; mean glandular doses