Aims and objectives
Breast density reporting is a legal requirement in several US states,
and clinical decisions are increasingly being made based upon these breast density results,
in the US and elsewhere.
The BI-RADS definition of the overall breast composition is “an assessment of the volume of attenuating tissues in the breast” [1].
Currently the radiologist assesses the volume of attenuating tissue in the breast by visually inspecting the craniocaudal (CC) and mediolateral oblique (MLO) mammograms and reporting the appropriate BI-RADS density category: 1) Almost entirely fatty; 2)...
Methods and materials
Digital breast tomosynthesis (DBT) uses a series of low-dose x-ray projections at various angles,
to reconstruct a pseudo-3D image of the breast.
There are several DBT systems available on the global market,
but only one with FDA approval (at time of writing): Hologic’s Selenia Dimensions 3D.
Initial FDA approval of the Dimensions System,
for screening,
required it to function in “combo” mode,
where conventional 2D mammograms are performed at the same time as the series of low-dose x-ray projections.
FDA approval has now been granted...
Results
Examples of some of the different image types that could potentially be used by radiologists to visually assess breast density are given in Figure 1 (note: as the C-View module is optional,
synthetic CC and MLO views were not available for the current study).
A comparison of the means for the various Volpara parameters,
indicate that there was no significant difference between VBD,
BV and FGV estimates from conventional mammograms or the DBT projections (Figure 2).
The overall mean VBD as assessed from the DBT...
Conclusion
Despite the significant implications of breast density in breast cancer screening,
few studies have investigated breast density assessments derived specifically from DBT images.
Tagliafico et al.
have compared several area-based density assessment methods for 2D mammograms and DBT projections.
Using a maximum entropy thresholding method,
the mean breast density was 11.4% higher on conventional mammography compared to the breast density obtained from the average density of the DBT projections [7].
Subsequent studies,
using semi-automated or fully-automated software,
demonstrated highly significant differences between the breast density...
Personal information
Chris Tromans,
PhD; Matakina Technology Ltd,
Wellington,
NZ;
[email protected]
Ralph Highnam,
PhD; Matakina Technology Ltd,
Wellington,
NZ;
[email protected]
Oliver Morrish; Cambridge University Hospitals NHS Foundation Trust,
Cambridge,
UK;
[email protected]
Richard Black; Cambridge University Hospitals NHS Foundation Trust,
Cambridge,
UK;
[email protected]
Lorraine Tucker; Department of Radiology,
University of Cambridge,
Cambridge,
UK
[email protected]
Fiona Gilbert,
MD; Department of Radiology,
University of Cambridge,
Cambridge,
UK;
[email protected]
References
[1] American College of Radiology.
Breast Imaging Reporting and Data System (BI-RADS).
4th ed.
Reston,
VA: American College of Radiology; 2003
[2] Ciatto et al.
The Breast.
2005; 14: 269-275
[3] Jeffreys et al.
IWDM 2010,
LNCS.
2010; 6136: 408-413
[4] Highnam et al.
IWDM 2010,
LCNS.
2010; 6136: 342-349
[5] Kontos et al.
Proceedings of SPIE Medical Imaging.
2010; 7624: 762409
[6] Wang et al.
PLoS One.
2013; 8: e81653
[7] Tagliafico et al.
Eur Radiol. 2012; 22: 1265 - 1270
[8] Tagliafico et...