Classification of fatty and dense breast parenchyma: comparison of automatic volumetric density measurement and radiologists' classification and their inter-observer variation

Acta Radiologica
Bjørn Helge ØsteråsP Skaane

Abstract

Automatically calculated breast density is a promising alternative to subjective BI-RADS density assessment. However, such software needs a cutoff value for density classification. To determine the volumetric density threshold which classifies fatty and dense breasts with highest accuracy compared to average BI-RADS density assessment, and to analyze radiologists' inter-observer variation. A total of 537 full field digital mammography examinations were randomly selected from a population based screening program. Five radiologists assessed density using the BI-RADS density scale, where BI-RADS I-II were classified as fatty and III-IV as dense. A commercially available software (Quantra) calculated volumetric breast density. We calculated the cutoff (threshold) values in volumetric density that yielded highest accuracy compared to median and individual radiologists' classification. Inter-observer variation was analyzed using the kappa statistic. The threshold that best matched the median radiologists' classification was 10%, which resulted in 87% accuracy. Thresholds that best matched individual radiologist's classification had a range of 8-15%. A total of 191 (35.6 %) cases were scored both dense and fatty by at least one radiol...Continue Reading

References

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Methods Mentioned

BETA
X-ray

Software Mentioned

Matlab
Quantra
Stata
SecurView

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