Intercountry analysis of breast density classification using visual grading

Damases, Christine N.; Hogg, Peter; McEntee, Mark F.

doi:10.1259/bjr.20170064

Cited by 8 publications

(7 citation statements)

References 38 publications

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“…This could be due to variable perception on the part of radiologists and can be improved by training based on standards and reference images [3]. However, this study's agreement levels are higher than previously reported studies which did not incorporate observer training, either oral or Atlas BI-RADS instruction [6,26,[42][43][44] but similar to studies that included clear BI-RADS instructions for participants [7]. This could be due to enrollment bias, as at the time of the research activity, both radiology cohorts were involved in specialized mammography-focussed activity, and breast density was considered an important topical issue.…”

Section: Discussioncontrasting

confidence: 55%

“…Many studies have been undertaken to test interobserver variability in assessing breast density. They vary in the number of radiologists included, the methodology used, and the results [6,25,26,[42][43][44]. However, this study sought to explore the establishment of the variation in two countries, the USA and UK, using a greater number of expert radiologists reviewing a larger number of images compared to previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies did not include radiologists from different countries and practices. To our knowledge, only one recently published study [26] has undertaken intercountry study, however, this study only used left breast images and a small number of images. Moreover, the UK image readers in Damases et al (2017) [26] only involved radiographer image readers.…”

Section: R Esultats : Les Radiologistes Desmentioning

confidence: 99%

“…To our knowledge, only one recently published study [26] has undertaken intercountry study, however, this study only used left breast images and a small number of images. Moreover, the UK image readers in Damases et al (2017) [26] only involved radiographer image readers. Therefore, this study endeavours to address this deficiency, by examining the inter-rater variability in categorizing breast density with a larger number of images (including right and left breast images) and a large group of radiologists from two jurisdictions, which have differing legal requirements related to breast density categorization.…”

Section: R Esultats : Les Radiologistes Desmentioning

confidence: 99%

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Variability of Breast Density Classification Between US and UK Radiologists

Alomaim

O'Leary

Ryan

et al. 2019

Journal of Medical Imaging and Radiation Sciences

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Purpose: To assess whether subjective breast density categorization remains the most useful way to categorize mammographic breast density and whether variations exist across geographic regions with differing national legislation. Methods: Breast radiologists from two countries (UK, USA) were voluntarily recruited to review sets of anonymized mammographic images (n ¼ 180) and additional repeated images (n ¼ 70), totaling 250 images, to subjectively rate breast density according to the Breast Imaging Reporting and Data system (BI-RADS) categorization. Images were reviewed using standardized viewing conditions and Ziltron software. Inter-rater reliability was analyzed using the Kappa test. Results: The US radiologists (n ¼ 25) judged fewer images as being ''mostly fatty'' than UK radiologists (n ¼ 24), leading a greater number of images classified in the higher BI-RADS categories, particularly in BI-RADS 3. Overall agreement for all data sets was k ¼ 0.654 indicating substantial agreement between the two cohorts. When the data were split into BI-RADS categories, the level of agreement varied from fair to substantial.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: R Esultats : Les Radiologistes Desmentioning

confidence: 99%

Section: R Esultats : Les Radiologistes Desmentioning

confidence: 99%

See 2 more Smart Citations

Variability of Breast Density Classification Between US and UK Radiologists

Alomaim

O'Leary

Ryan

et al. 2019

Journal of Medical Imaging and Radiation Sciences

View full text Add to dashboard Cite

show abstract

“…It has been suggested that radiographers could do breast density assessment, but this has been shown to result in even less agreement (kappa 0.69 versus 0.62) (184 (197). Still, even when using their native scales, readers from U.K. had worse agreement compared to readers from U.S., with even lower agreement among Australian radiologists (198). This indicates that BI-RADS density has relatively higher agreement compared to alternative subjective scales.…”

Section: Moving From Subjective To Objective Breast Density Assessmentmentioning

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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