OBJECTIVE: The purpose of this study was to compare visual assessments of mammographic breast density by radiologists using BI-RADS 4th and 5th editions in correlation with automated volumetric breast density measurements. MATERIALS AND METHODS: A total of 337 consecutive full-field digital mammographic examinations with standard views were retrospectively assessed by two radiologists for mammographic breast density according to BI-RADS 4th and 5th editions. Fully automated measurement of the volume of fibroglandular tissue and total breast and percentage breast density was performed with a commercially available software program. Interobserver and intraobserver agreement was assessed with kappa statistics. The distributions of breast density categories for both editions of BI-RADS were compared and correlated with volumetric data. RESULTS: Interobserver agreement on breast density category was moderate to substantial (κ = 0.58-0.63) with use of BI-RADS 4th edition and substantial (κ = 0.63-0.66) with use of the 5th edition but without significant difference between the two editions. For intraobserver agreement between the two editions, the distributions of density category were significantly different (p < 0.0001), the proportions of dense breast increased, and the proportion of fatty breast decreased with use of the 5th edition compared with the 4th edition (p < 0.0001). All volumetric breast density data, including percentage breast density, were significantly different among density categories (p < 0.0001) and had significant correlation with visual assessment for both editions of BI-RADS (p < 0.01). CONCLUSION: Assessment using BI-RADS 5th edition revealed a higher proportion of dense breast than assessment using BI-RADS 4th edition. Nevertheless, automated volumetric density assessment had good correlation with visual assessment for both editions of BI-RADS.
OBJECTIVE: The purpose of this study was to compare visual assessments of mammographic breast density by radiologists using BI-RADS 4th and 5th editions in correlation with automated volumetric breast density measurements. MATERIALS AND METHODS: A total of 337 consecutive full-field digital mammographic examinations with standard views were retrospectively assessed by two radiologists for mammographic breast density according to BI-RADS 4th and 5th editions. Fully automated measurement of the volume of fibroglandular tissue and total breast and percentage breast density was performed with a commercially available software program. Interobserver and intraobserver agreement was assessed with kappa statistics. The distributions of breast density categories for both editions of BI-RADS were compared and correlated with volumetric data. RESULTS: Interobserver agreement on breast density category was moderate to substantial (κ = 0.58-0.63) with use of BI-RADS 4th edition and substantial (κ = 0.63-0.66) with use of the 5th edition but without significant difference between the two editions. For intraobserver agreement between the two editions, the distributions of density category were significantly different (p < 0.0001), the proportions of dense breast increased, and the proportion of fatty breast decreased with use of the 5th edition compared with the 4th edition (p < 0.0001). All volumetric breast density data, including percentage breast density, were significantly different among density categories (p < 0.0001) and had significant correlation with visual assessment for both editions of BI-RADS (p < 0.01). CONCLUSION: Assessment using BI-RADS 5th edition revealed a higher proportion of dense breast than assessment using BI-RADS 4th edition. Nevertheless, automated volumetric density assessment had good correlation with visual assessment for both editions of BI-RADS.
Keywords:
BI-RADS; breast density; breast imaging; computer-assisted interpretation; mammography
Authors: B L Sprague; K Kerlikowske; E J A Bowles; G H Rauscher; C I Lee; A N A Tosteson; D L Miglioretti Journal: J Natl Cancer Inst Date: 2019-06-01 Impact factor: 13.506
Authors: Aimilia Gastounioti; Shyam Desai; Vinayak S Ahluwalia; Emily F Conant; Despina Kontos Journal: Breast Cancer Res Date: 2022-02-20 Impact factor: 8.408