Korean J Radiol.  2014 Jun;15(3):313-321. 10.3348/kjr.2014.15.3.313.

Mammographic Density Estimation with Automated Volumetric Breast Density Measurement

• Ko SY
• Kim EK
• Kim MJ
• Moon HJ

• KMID: 2078640
• DOI: http://doi.org/10.3348/kjr.2014.15.3.313

Abstract

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.
MATERIALS AND 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).
CONCLUSION
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.

Keyword

Mammographic breast density; Volumetric breast density measurement; American College of Radiology Breast Imaging Reporting and Data System

MeSH Terms

Adult
Aged
Breast Neoplasms/classification/*radiography/surgery
Female
Humans
Mammary Glands, Human/*abnormalities/surgery
*Mammography
Mastectomy/methods
Middle Aged
Observer Variation
*Radiology
Retrospective Studies
Young Adult

Figure

• 

  Fig. 1 Mammogram performed in 46-year-old woman during routine check-up. A, B. Radiologist estimated that fibroglandular tissue volume accounted for more than 50% of total breast volume and reported grade 3 parenchymal density. C. Volumes of total breast tissue (mL) and fibroglandular tissue (mL) in each breast are automatically presented by volumetric breast density measurement as shown above. Volumetric breast density is calculated as volume of fibroglandular tissue divided by volume of total breast tissue, expressed as percentage. Density grade by volumetric breast density measurement is presented as mean of two breast densities.

• 

  Fig. 2 Mammogram performed in 60-year-old woman during routine check-up following left partial mastectomy. A, B. Radiologist estimated that fibroglandular tissue volume accounted for more than 50% of total breast volume and reported grade 3 parenchymal density. Left-sided mammogram showed postoperative architectural distortion in upper outer portion. C. Volume and density were "0", which indicated technical failure. Volumetric breast density measurement showed right-sided volume and density only and presented grade 3 parenchymal density.

• 

  Fig. 3 Mammogram performed in 55-year-old woman during routine check-up. A, B. Radiologist estimated that fibroglandular tissue volume accounted for more than 50% of total breast volume and reported grade 3 parenchymal density. C. Volumetric breast density measurement also produced grade 3 parenchymal density.

• 

  Fig. 4 Mammogram performed in 56-year-old woman during routine check-up. A, B. Radiologist estimated that fibroglandular tissue volume accounted for more than 50% of total breast volume and reported grade 3 parenchymal density. C. However, volumetric breast density measurement evaluated parenchymal density as grade 4.

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