Youk Ji Hyun, Gweon Hye Mi, Son Eun Ju, Kim Jeong-Ah
1 Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-Gu, Seoul 06273, South Korea.
AJR Am J Roentgenol. 2016 May;206(5):1056-62. doi: 10.2214/AJR.15.15472. Epub 2016 Mar 2.
The purpose of this study is to evaluate automated volumetric measurements in comparison with visual assessment of mammographic breast density by use of the fifth edition of BI-RADS.
A total of 1185 full-field digital mammography examinations with standard views were retrospectively analyzed. All images were visually assessed by two blinded radiologists according to breast density category in the fifth edition of the BI-RADS lexicon. Automated volumetric breast density assessment was performed using two different software programs, Quantra and Volpara. A weighted kappa value was calculated to assess the degree of agreement among the visual and volumetric assessments of the density category. The volumes of fibroglandular tissue or total breast and the percentage breast density provided by the two software programs were compared.
Compared with a visual assessment, the agreement of density category ranged from moderate to substantial in Quantra (κ = 0.54-0.61) and fair to moderate in Volpara (κ = 0.32-0.43). The distribution of density category was statistically significantly different among visual and volumetric measurements (p < 0.0001). Quantra assigned category A and B (43.5%) more frequently than did the radiologists (25.6%) or Volpara (16.0%). Volpara assigned category D (42.1%) more frequently than did the radiologists (19.5%) or Quantra (15.4%). Between the two software programs, the means of all volumetric data were statistically significantly different (p < 0.0001), but were well correlated (γ = 0.79-0.99; p < 0.0001).
More mammographic examinations were classified as nondense breast tissue using the Quantra software and as dense breast tissue using the Volpara software, as compared with visual assessments according to the BI-RADS fifth edition.
本研究旨在通过使用乳腺影像报告和数据系统（BI-RADS）第五版，评估自动体积测量与乳腺钼靶密度视觉评估的对比情况。
回顾性分析了1185例具有标准视图的全视野数字化乳腺钼靶检查。两名盲法放射科医生根据BI-RADS词典第五版中的乳腺密度类别对所有图像进行了视觉评估。使用两种不同的软件程序Quantra和Volpara进行自动体积乳腺密度评估。计算加权kappa值以评估密度类别视觉评估与体积评估之间的一致程度。比较了两种软件程序提供的纤维腺体组织或全乳体积以及乳腺密度百分比。
与视觉评估相比，Quantra软件中密度类别的一致性从中度到高度（κ = 0.54 - 0.61），Volpara软件中为一般到中度（κ = 0.32 - 0.43）。密度类别分布在视觉测量和体积测量之间存在统计学显著差异（p < 0.0001）。Quantra软件将A类和B类（43.５%）的分配频率高于放射科医生（25.6%）或Volpara软件（16.0%）。Volpara软件将D类（42.1%）的分配频率高于放射科医生（19.5%）或Quantra软件（15.4%）。在两种软件程序之间，所有体积数据的均值存在统计学显著差异（p < 0.0001），但相关性良好（γ = 0.79 - 0.99；p < 0.0001）。
与根据BI-RADS第五版进行的视觉评估相比，使用Quantra软件时更多的乳腺钼靶检查被分类为非致密乳腺组织，而使用Volpara软件时更多被分类为致密乳腺组织。
