Volumetric breast density measurement: sensitivity analysis of a relative physics approach

Lau, Susie; Ng, Kwan Hoong; Aziz, Yang Faridah Abdul

doi:10.1259/bjr.20160258

Cited by 11 publications

(3 citation statements)

References 42 publications

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“…The general concepts underlying each algorithm are similar, although there are some notable differences. Quantra uses an absolute physics model, in contrast to the relative physics approach used by Volpara, which finds in each image, a pixel signal corresponding to purely adipose tissue that is used as an internal reference [ 57 , 58 ]. Pixels that are deemed to correspond to significant amounts of dense tissue are also used to determine an area-based estimate of MBD by Quantra.…”

Section: Fully-automated Density Assessmentmentioning

confidence: 99%

Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

Destounis¹,

Arieno²,

Morgan³

et al. 2017

Diagnostics

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Mammographic breast density (MBD) has been proven to be an important risk factor for breast cancer and an important determinant of mammographic screening performance. The measurement of density has changed dramatically since its inception. Initial qualitative measurement methods have been found to have limited consistency between readers, and in regards to breast cancer risk. Following the introduction of full-field digital mammography, more sophisticated measurement methodology is now possible. Automated computer-based density measurements can provide consistent, reproducible, and objective results. In this review paper, we describe various methods currently available to assess MBD, and provide a discussion on the clinical utility of such methods for breast cancer screening.

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Section: Fully-automated Density Assessmentmentioning

confidence: 99%

Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

Destounis¹,

Arieno²,

Morgan³

et al. 2017

Diagnostics

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“…Both are model based, but work in slightly different ways to calculate dense volume, total breast volume and percent volumetric MD (VBD) from individual pixel intensities and known xray attenuations. Quantra uses an absolute model and includes the skin; Volpara uses a relative physics model by finding a pixel of pure fat attenuation as an internal reference(118). As well as yielding dense and total breast volumes, Volpara gives a density grade (VDG) that can be aligned to the 4 th or 5 th edition of BI-RADS and Quantra gives a similar measure (figure 7).…”

mentioning

confidence: 99%

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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“…The use of different imaging systems between DM and CEM exams may actually have a greater influence on the variability of density results. For example, it is known that a change in compression paddle type can influence the amount of tissue in the field of view [ 53 ], and the combination of machine/paddle/compression modes can influence the accuracy of compressed thickness readout [ 54 ], both of which can influence the VBD estimate accuracy [ 55 ]. Only one automated density measurement tool was used in this study, which was a research-specific version compatible with LE-CEM.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Breast Density in Contrast-Enhanced Mammography

Gennaro

Hill²,

Bezzon

et al. 2021

JCM

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Contrast-enhanced mammography (CEM) demonstrates a potential role in personalized screening models, in particular for women at increased risk and women with dense breasts. In this study, volumetric breast density (VBD) measured in CEM images was compared with VBD obtained from digital mammography (DM) or tomosynthesis (DBT) images. A total of 150 women who underwent CEM between March 2019 and December 2020, having at least a DM/DBT study performed before/after CEM, were included. Low-energy CEM (LE-CEM) and DM/DBT images were processed with automatic software to obtain the VBD. VBDs from the paired datasets were compared by Wilcoxon tests. A multivariate regression model was applied to analyze the relationship between VBD differences and multiple independent variables certainly or potentially affecting VBD. Median VBD was comparable for LE-CEM and DM/DBT (12.73% vs. 12.39%), not evidencing any statistically significant difference (p = 0.5855). VBD differences between LE-CEM and DM were associated with significant differences of glandular volume, breast thickness, compression force and pressure, contact area, and nipple-to-posterior-edge distance, i.e., variables reflecting differences in breast positioning (coefficient of determination 0.6023; multiple correlation coefficient 0.7761). Volumetric breast density was obtained from low-energy contrast-enhanced spectral mammography and was not significantly different from volumetric breast density measured from standard mammograms.

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Volumetric breast density measurement: sensitivity analysis of a relative physics approach

Cited by 11 publications

References 42 publications

Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

Breast density: why all the fuss?

Quantitative Breast Density in Contrast-Enhanced Mammography

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