Rationale and Objectives
To investigate agreement on mammographic breast density (MD) assessment between automated
volumetric software and Breast Imaging Reporting and Data System (BIRADS) categorization
by expert radiologists.
Materials and Methods
Forty cases of left craniocaudal and mediolateral oblique mammograms from 20 women
were used. All images had their volumetric density classified using Volpara density
grade (VDG) and average volumetric breast density percentage. The same images were
then classified into BIRADS categories (I–IV) by 20 American Board of Radiology examiners.
Results
The results demonstrated a moderate agreement (κ = 0.537; 95% CI = 0.234–0.699) between
VDG classification and radiologists' BIRADS density assessment. Interreader agreement
using BIRADS also demonstrated moderate agreement (κ = 0.565; 95% CI = 0.519–0.610)
ranging from 0.328 to 0.669. Radiologists' average BIRADS was lower than average VDG
scores by 0.33, with their mean being 2.13, whereas the mean VDG was 2.48 (U = −3.742;
P < 0.001). VDG and BIRADS showed a very strong positive correlation (ρ = 0.91; P < 0.001) as did BIRADS and average volumetric breast density percentage (ρ = 0.94;
P < 0.001).
Conclusions
Automated volumetric breast density assessment shows moderate agreement and very strong
correlation with BIRADS; interreader variations still exist within BIRADS. Because
of the increasing importance of MD measurement in clinical management of patients,
widely accepted, reproducible, and accurate measures of MD are required.
Key Words
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Article info
Publication history
Published online: October 27, 2015
Accepted:
September 16,
2015
Received in revised form:
August 31,
2015
Received:
June 16,
2015
Identification
Copyright
© 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
