Comparison Between Digital and Synthetic 2D Mammograms in Breast Density Interpretation

Alshafeiy, Taghreed; Wadih, Antoine; Nicholson, Brandi T.; Rochman, Carrie M.; Peppard, Heather R.; Patrie, James T.; Harvey, Jennifer A.

doi:10.2214/ajr.16.16966

Cited by 25 publications

(6 citation statements)

References 19 publications

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“…A trend toward downgrading BI-RADS density at screening with synthetic mammography versus digital mammography was reported in two recent retrospective studies of outcomes of synthetic mammography and DBT screening (15,22). Also, two retrospective studies (23,24) with 200 and 309 women reported comparable breast density assignments by using digital mammography and synthetic mammography images. To our knowledge, ours is the first large-scale study to evaluate the effect of mammographic screening modality on breast density readings in actual clinical practice where digital mammography and synthetic mammography images are read together with the quasithree-dimensional DBT volume since DBT is acquired.…”

Section: Discussionmentioning

confidence: 85%

Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis

et al. 2019

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ammographic breast density reflects the relative amounts of fat versus fibroglandular tissues in the breast (1) and is an established risk factor for breast cancer (2). Women with the highest level of breast density have four to six times the risk for breast cancer compared with women with the lowest levels of density (3), and high density is associated with larger and more aggressive tumors (4). Moreover, breast density can affect the sensitivity of mammography because of masking of tumors (5). As of December 2018, over 70% of states in the United States passed legislation mandating that women be notified of their breast density. In some states, women with high breast density are advised to both discuss the implication of their density with their health care provider and consider supplemental screening methods (6). The most commonly used breast density assessment is the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) (1). The BI-RADS system includes four categories of breast density (a, almost entirely fatty; b, scattered areas of fibroglandular density; c, hetereogeneously dense; and, d, extremely dense). According to most state notification laws, women assigned the latter two breast density categories are considered to have dense breasts whereas the first two density categories are considered nondense. In many states, having dense breast parenchyma prompts supplemental screening, most often with breast US. Studies show a strong relationship of high BI-RADS breast density categories to cancer risk (2), risk of masking (5), and high-risk benign breast disease (7).

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Section: Discussionmentioning

confidence: 85%

Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis

et al. 2019

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“…BI-RADS density classification of synthetic 2D mammograms derived from DBT has been compared with with standard DM, with good agreement for individual readers (80%; Cohens kappa 0.73) and excellent agreement when images were dichotomised into dense and non-dense (92%) (138). Good agreement has also been demonstrated for Hologic Selenia Dimensions 'C-View' synthetic mammograms and standard Selenia DM using LIBRA (139).…”

Section: Dbt and Synthetic 2d Dmmentioning

confidence: 96%

Breast density: why all the fuss?

Vinnicombe

2018

Clinical Radiology

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The term "breast density" or mammographic density (MD) denotes those components of breast parenchyma visualised at mammography that are denser than adipose tissue. MD is composed of a mixture of epithelial and stromal components, notably collagen, in variable proportions. MD is most commonly assessed in clinical practice with the time-honoured method of visual estimation of area-based percent density (PMD) on a mammogram, with categorisation into quartiles. The computerised semi-automated thresholding method, Cumulus, also yielding area-based percent density, is widely used for research purposes; however, the advent of fully automated volumetric methods developed as a consequence of the widespread use of digital mammography (DM) and yielding both absolute and percent dense volumes, has resulted in an explosion of interest in MD recently. Broadly, the importance of MD is twofold: firstly, the presence of marked MD significantly reduces mammographic sensitivity for breast cancer, even with state-of-the-art DM. Recognition of this led to the formation of a powerful lobby group ('Are You Dense') in the US, as a consequence of which 32 states have legislated for mandatory disclosure of MD to women undergoing mammography. Secondly, it is now widely accepted that MD is in itself a risk factor for breast cancer, with a four-to sixfold increased relative risk in women with PMD in the highest quintile compared to those with PMD in the lowest quintile. Consequently, major research efforts are underway to assess whether use of MD could provide a major step forward towards risk-adapted, personalised breast cancer prevention, imaging, and treatment.

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“…Two laboratory studies have shown comparable breast density assessment in synthetic 2D images and conventional DM images (212,213…”

Section: Subjective Breast Density Assessment In Digital Breast Tomosmentioning

confidence: 99%

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

et al. 2018

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The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra. AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

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Comparison Between Digital and Synthetic 2D Mammograms in Breast Density Interpretation

Cited by 25 publications

References 19 publications

Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis

Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis

Breast density: why all the fuss?

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

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