Correlates of mammographic density in B-mode ultrasound and real time elastography

Abstract

The aim of our study involved the assessment of B-mode imaging and elastography with regard to their ability to predict mammographic density (MD) without X-rays. Women, who underwent routine mammography, were prospectively examined with additional B-mode ultrasound and elastography. MD was assessed quantitatively with a computer-assisted method (Madena). The B-mode and elastography images were assessed by histograms with equally sized gray-level intervals. Regression models were built and cross validated to examine the ability to predict MD. The results of this study showed that B-mode imaging and elastography were able to predict MD. B-mode seemed to give a more accurate prediction. R for B-mode image and elastography were 0.67 and 0.44, respectively. Areas in the B-mode images that correlated with mammographic dense areas were either dark gray or of intermediate gray levels. Concerning elastography only the gray levels that represent extremely stiff tissue correlated positively with MD. In conclusion, ultrasound seems to be able to predict MD. Easy and cheap utilization of regular breast ultrasound machines encourages the use of ultrasound in larger case-control studies to validate this method as a breast cancer risk predictor. Furthermore, the application of ultrasound for breast tissue characterization could enable comprehensive research concerning breast cancer risk and breast density in young and pregnant women.

RANKL and OPG and their influence on breast volume changes during pregnancy in healthy women

“…Trying to establish measurable phenotypes of breast changes during pregnancy, our group previously developed a surface-based 3D method of measuring the female breast 19 and validated the method in a cohort of pregnant women 20 . Validation of a method of calculating mammographic density using ultrasound 28 in a cohort of pregnant women is still ongoing. There have been a few earlier studies that had similar aims with the technical www.nature.com/scientificreports www.nature.com/scientificreports/ methods that were available in the 1990s 29,30 .…”

“…It could be hypothesized that pregnancy in these two groups of women has a different effect on the breast after pregnancy, which has to be further investigated. Moreover, to examine changes of the breast with regard to breast cancer risk and other phenotypes, such as predicted breast density by ultrasound 28 , might be helpful.…”

Looking beyond the mammogram to assess mammographic density: A narrative review

“…It is a single-sided, pulse-echo technique that produces an image of the breast where voxel grey-level is related to the relative acoustic impedance of different tissue types. Although the volume of B-Mode-US may be used to obtain a quantitative measure of a breast lesion, B-Mode US cannot measure an analogous-MD quantity, although it has been shown that B-mode US is able to predict MD measured by mammogram based on the distribution of grey-level values in the US image (R 2 = 0.67 coefficient of determination from ULR analysis) [58]. The same voxel grey-scale analysis has been performed using US elastogram images, but was shown to be less predictive of MD measured by mammogram (R 2 = 0.44 coefficient of determination from ULR analysis) [58].…”

Differences in breast density assessment using mammography, tomosynthesis and MRI and their implications for practice

“…Different authors have added elastography to Bmode ultrasound evaluation of the breast. It was found that only the grey levels correlated positively with mammographic breast density and the elastographic data [34]. To date, the use of ultrasound in large case-control studies has not been validated as a breast cancer risk predictor.…”

“…To date, the use of ultrasound in large case-control studies has not been validated as a breast cancer risk predictor. The use of ultrasound for breast tissue characterisation could be considered in young and pregnant women [34]. Further researches may compare breast percentage density evaluated on ultrasound with the data derived from MRI and DBT.…”