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Intraindividual Comparison of Two Methods of Volumetric Breast Composition Assessment

      Rationale and Objectives

      To compare the results of two software-based methods, Quantra and Volpara, for volumetric breast composition assessment.

      Materials and Methods

      Four hundred forty-five normal, bilateral, two-view, digital mammograms were included. Breast volume (BV), fibroglandular tissue volume (FTV), and percent density (PD) were measured using both methods and compared. Deming regression was performed to obtain linear equations for mapping the results of one software on the other.

      Results

      The median and quartile ranges of both methods agreed well for BV but were different for FTV and PD, with Quantra showing much higher values of FTV and PD. The correlation of results obtained by both methods for BV, FTV, and PD was 0.99, 0.91, and 0.94, respectively. Intraclass correlation in the assignment of quartiles of BV, FTV, and PD was 0.96, 0.86, and 0.90, respectively. Both methods showed a similar association of FTV and PD with patient age and similar left-to-right correlation. Mapping of results onto each other using linear equations removed the systematic differences.

      Conclusions

      Although Quantra and Volpara use different models for analysis of volumetric breast composition and produce different nominal results of FTV and PD, both methods are highly correlated and show very good to excellent agreement in quartile assignment of all parameters measured. Both methods show a similar association with patient age and similar reproducibility. Both methods can be mapped onto each other using the equations suggested.

      Key Words

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      References

        • Assi V.
        • Warwick J.
        • Cuzick J.
        • et al.
        Clinical and epidemiological issues in mammographic density.
        Nat Rev Clin Oncol. 2012; 9: 33-40
        • McCormack V.A.
        • dos Santos Silva I.
        Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis.
        Cancer Epidemiol Biomarkers Prev. 2006; 15: 1159-1169
        • Cuzick J.
        • Warwick J.
        • Pinney E.
        • et al.
        Tamoxifen-induced reduction in mammographic density and breast cancer risk reduction: a nested case-control study.
        J Natl Cancer Inst. 2011; 103: 744-752
        • Li J.
        • Humphreys K.
        • Eriksson L.
        • et al.
        Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer.
        J Clin Oncol. 2013; 31: 2249-2256
        • Maskarinec G.
        • Pagano I.S.
        • Little M.A.
        • et al.
        Mammographic density as a predictor of breast cancer survival: the Multiethnic Cohort.
        Breast Cancer Res. 2013; 15: R7
        • Sandberg M.E.
        • Li J.
        • Hall P.
        • et al.
        Change of mammographic density predicts the risk of contralateral breast cancer—a case-control study.
        Breast Cancer Res. 2013; 15: R57
        • Drukteinis J.S.
        • Mooney B.P.
        • Flowers C.I.
        • et al.
        Beyond mammography: new frontiers in breast cancer screening.
        Am J Med. 2013; 126: 472-479
        • Bernardi D.
        • Pellegrini M.
        • Di Michele S.
        • et al.
        Interobserver agreement in breast radiological density attribution according to BI-RADS quantitative classification.
        Radiol Med. 2012; 117: 519-528
        • Ciatto S.
        • Houssami N.
        • Apruzzese A.
        • et al.
        Categorizing breast mammographic density: intra- and interobserver reproducibility of BI-RADS density categories.
        Breast. 2005; 14: 269-275
        • Ooms E.A.
        • Zonderland H.M.
        • Eijkemans M.J.
        • et al.
        Mammography: interobserver variability in breast density assessment.
        Breast. 2007; 16: 568-576
        • Byng J.W.
        • Boyd N.F.
        • Fishell E.
        • et al.
        The quantitative analysis of mammographic densities.
        Phys Med Biol. 1994; 39: 1629-1638
        • Engelken F.
        • Singh J.M.
        • Fallenberg E.M.
        • et al.
        Volumetric breast composition analysis: reproducibility of breast percent density and fibroglandular tissue volume measurements in serial mammograms.
        Acta Radiol. 2014; 55: 32-38
        • Singh J.M.
        • Fallenberg E.M.
        • Diekmann F.
        • et al.
        Volumetric breast density assessment: reproducibility in serial examinations and comparison with visual assessment.
        Rofo. 2013; 185: 844-848
        • van Engeland S.
        • Snoeren P.R.
        • Huisman H.
        • et al.
        Volumetric breast density estimation from full-field digital mammograms.
        IEEE Trans Med Imaging. 2006; 25: 273-282
        • Ciatto S.
        • Bernardi D.
        • Calabrese M.
        • et al.
        A first evaluation of breast radiological density assessment by QUANTRA software as compared to visual classification.
        Breast. 2012; 21: 503-506
        • Jeffreys M.
        • Warren R.
        • Highnam R.
        • et al.
        Initial experiences of using an automated volumetric measure of breast density: the standard mammogram form.
        Br J Radiol. 2006; 79: 378-382
        • Gweon H.M.
        • Youk J.H.
        • Kim J.A.
        • et al.
        Radiologist assessment of breast density by BI-RADS categories versus fully automated volumetric assessment.
        AJR Am J Roentgenol. 2013; 201: 692-697
        • Seo J.M.
        • Ko E.S.
        • Han B.K.
        • et al.
        Automated volumetric breast density estimation: a comparison with visual assessment.
        Clin Radiol. 2013; 68: 690-695
        • Wang J.
        • Azziz A.
        • Fan B.
        • et al.
        Agreement of mammographic measures of volumetric breast density to MRI.
        PLoS One. 2013; 8: e81653
        • Hammann-Kloss J.S.
        • Bick U.
        • Fallenberg E.
        • et al.
        Volumetric quantification of the effect of aging and hormone replacement therapy on breast composition from digital mammograms.
        Eur J Radiol. 2014; 83: 1092-1097
        • Skippage P.
        • Wilkinson L.
        • Allen S.
        • et al.
        Correlation of age and HRT use with breast density as assessed by Quantra.
        Breast J. 2013; 19: 79-86
        • Redondo A.
        • Comas M.
        • Macia F.
        • et al.
        Inter- and intraradiologist variability in the BI-RADS assessment and breast density categories for screening mammograms.
        Br J Radiol. 2012; 85: 1465-1470
        • Chmura Kraemer H.
        • Periyakoil V.S.
        • Noda A.
        Kappa coefficients in medical research.
        Stat Med. 2002; 21: 2109-2129
      1. Sauber N, Chan A, Highnam R. BI-RADS breast density classification - an international standard? Poster Presentation presented at: European Congress of Radiology. Vienna, Austria 2013 Mar 7-11.