Martínez Gómez I, Casals El Busto M, Antón Guirao J, Ruiz Perales F, Llobet Azpitarte R
Programa de Cribado de Cáncer de Mama de la Comunidad Valenciana, Unidad de Alzira, Alzira, Valencia, España.
Programa de Cribado de Cáncer de Mama de la Comunidad Valenciana, Unidad de Valencia, Valencia, España.
Radiologia. 2014 Sep-Oct;56(5):429-34. doi: 10.1016/j.rx.2012.11.007. Epub 2013 Mar 13.
To evaluate the reproducibility of the calculation of breast density with DM-Scan software, which is based on the semiautomatic segmentation of fibroglandular tissue, and to compare it with the reproducibility of estimation by visual inspection.
The study included 655 direct digital mammograms acquired using craniocaudal projections. Three experienced radiologists analyzed the density of the mammograms using DM-Scan, and the inter- and intra-observer agreement between pairs of radiologists for the Boyd and BI-RADS® scales were calculated using the intraclass correlation coefficient. The Kappa index was used to compare the inter- and intra-observer agreements with those obtained previously for visual inspection in the same set of images.
For visual inspection, the mean interobserver agreement was 0,876 (95% CI: 0,873-0,879) on the Boyd scale and 0,823 (95% CI: 0,818-0,829) on the BI-RADS® scale. The mean intraobserver agreement was 0,813 (95% CI: 0,796-0,829) on the Boyd scale and 0,770 (95% CI: 0,742-0,797) on the BI-RADS® scale. For DM-Scan, the mean inter- and intra-observer agreement was 0,92, considerably higher than the agreement for visual inspection.
The semiautomatic calculation of breast density using DM-Scan software is more reliable and reproducible than visual estimation and reduces the subjectivity and variability in determining breast density.
评估基于纤维腺组织半自动分割的DM-Scan软件计算乳腺密度的可重复性，并将其与视觉检查估计的可重复性进行比较。
本研究纳入了655例使用头尾位投照获得的直接数字化乳腺钼靶片。三名经验丰富的放射科医生使用DM-Scan分析乳腺钼靶片的密度，并使用组内相关系数计算成对放射科医生之间的观察者间和观察者内对博伊德（Boyd）和BI-RADS®分级的一致性。使用Kappa指数将观察者间和观察者内的一致性与之前在同一组图像中进行视觉检查所获得的一致性进行比较。
对于视觉检查，在博伊德分级上观察者间的平均一致性为0.876（95%可信区间：0.873 - 0.879），在BI-RADS®分级上为0.823（95%可信区间：0.818 - 0.829）。在博伊德分级上观察者内的平均一致性为0.813（95%可信区间：0.796 - 0.829），在BI-RADS®分级上为0.770（95%可信区间：0.742 - 0.797）。对于DM-Scan，观察者间和观察者内的平均一致性为0.92，显著高于视觉检查的一致性。
使用DM-Scan软件半自动计算乳腺密度比视觉估计更可靠、更具可重复性，并且减少了确定乳腺密度时的主观性和变异性。
