Gemici Ayşegül Akdoğan, Arıbal Erkin, Özaydın Ayşe Nilüfer, Gürdal Sibel Özkan, Özçınar Beyza, Cabioğlu Neslihan, Özmen Vahit
Department of Radiology, Health Science University, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
Department of Radiology, Acıbadem Mehmet Aydınlar University School of Medicine, İstanbul, Turkey.
Eur J Breast Health. 2020 Apr 1;16(2):110-116. doi: 10.5152/ejbh.2020.4943. eCollection 2020 Apr.
We aimed to compare visual and quantitative measurements of breast density and to reveal the density profile with compression characteristics.
Screening mammograms of 1399 women between May 2014 and May 2015 were evaluated by using Volpara 4 and 5 version. First 379 mammograms were assessed according to ACR BI-RADS 4 edition and compared to Volpara. We categorized the breast density in two subgroups as dens or non-dens. Two radiologists reviewed the images in consensus. Agreement level between visual and volumetric methods and volumetric methods between themselves assessed using weighted kappa statistics. Volpara data such as fibroglandular volume (FGV), breast volume (BV), compression thickness (CT), compression force (CF), compression pressure (CP) were also analyzed with relation to the age.
1399 mammograms were distributed as follows: 12.7% VDG1, 39.3% VDG2, 34.1% VDG3, 13.9% VDG4 according to the 4th edition of Volpara; 1.2% VDG1, 46% VDG2, 36.8% VDG3, 15.9% VDG4 according to the 5 edition of Volpara. The difference between two editions was 4.7% increase in dense category. 379 mammograms, according to ACR BI-RADS 4 edition, were distributed as follows: 25.9% category A, 50.9% category B, 19.8% category C, 3.4% category D. The strength of agreement between the Volpara 4 and 5 editions was found substantial (k=0.726). The agreements between visual assessment and both Volpara editions were poor (k=-0.413, k=-0.399 respectively). There was a 142% increase in dense group with the VDG 4 edition and 162% with the VDG 5 edition when compared to visual assessment. Compression force decreased while compression pressure increased with increasing Volpara Density Grade (VDG) (p for trend <0.001 for both). Compression thickness and breast volume decreased with increasing VDG (p for trend <0.001 for both). The FGV decreases with age and the breast volume increases with increasing age (p<0.001).
Visual assessment of breast density doesn't correlate well with volumetric assessments. Obtaining additional information about physical parameters and breast profile by the results of quantified methods is important for breast cancer risk assessments and prevention strategies.
我们旨在比较乳腺密度的视觉和定量测量，并揭示具有压迫特征的密度分布情况。
使用Volpara 4版和5版对2014年5月至2015年5月期间1399名女性的乳腺筛查钼靶片进行评估。首先根据美国放射学会（ACR）乳腺影像报告和数据系统（BI-RADS）第4版对379例钼靶片进行评估，并与Volpara进行比较。我们将乳腺密度分为致密型和非致密型两个亚组。两名放射科医生达成共识后对图像进行审查。使用加权kappa统计量评估视觉和体积测量方法之间以及体积测量方法之间的一致性水平。还分析了Volpara数据，如纤维腺体体积（FGV）、乳房体积（BV）、压迫厚度（CT）、压迫力（CF）、压迫压力（CP）与年龄的关系。
根据Volpara第4版，1399例钼靶片分布如下：12.7%为VDG1，39.3%为VDG2，34.1%为VDG3，13.9%为VDG4；根据Volpara第5版，1.2%为VDG1，46%为VDG2，36.8%为VDG3，15.9%为VDG4。两个版本之间的差异是致密类别增加了4.7%。根据ACR BI-RADS第4版，379例钼靶片分布如下：25.9%为A类，50.9%为B类，19.8%为C类，3.4%为D类。发现Volpara 4版和5版之间的一致性强度较高（kappa值=0.726）。视觉评估与两个Volpara版本之间的一致性都较差（kappa值分别为-0.413和-0.399）。与视觉评估相比，致密组在VDG 4版时增加了142%，在VDG 5版时增加了162%。随着Volpara密度等级（VDG）的增加，压迫力降低而压迫压力增加（两者趋势p均<0.001）。压迫厚度和乳房体积随着VDG的增加而减小（两者趋势p均<0.001）。FGV随年龄增长而降低，乳房体积随年龄增长而增加（p<0.001）。
乳腺密度的视觉评估与体积评估相关性不佳。通过定量方法的结果获取有关物理参数和乳房分布的额外信息对于乳腺癌风险评估和预防策略很重要。
