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Keywords:
Quality assurance, Computer Applications-General, Mammography, Breast
Authors:
L. Han Na, Y.-M. Sohn; Seoul/KR
DOI:
10.1594/ecr2014/C-1957
Results
Demographic characteristics
The mean age of the 860 patients was 54.7±10.2 years old (range 26-89 years).
The 760 patients had undergone mammography for screening,
the remaining 100 patients were performed mammography for diagnostic purpose.
The frequency of the breast density assessed by two radiologists and automated volumetric breast density measurement are listed in Table 1.
The most frequently observed breast density was category 3 in both radiologists and Volpara (Table 2).
The interobserver agreement for the evaluation of breast density by BI-RADS category were good (weighted k value=0.835,
95% CI; 0.8098-0.8608) and the agreements for the BI-RADS category between a radiologist specialized in breast imaging (S.Y.M.) and Volpara density grade showed moderate agreements (weighted k value = 0.799,
95% CI; 0.7708-0.8263).
A significant positive correlation was observed between BI-RADS categories assessed by the experienced radiologist and volumetric breast density assessed by fully automated volumetric breast density (ρ=0.8566,
p<0.0001 ) (Fig.
3).
Volpara breast density that was recategorized as fatty or dense group showed significant association with the mammographic BI-RADS final assessment (p<0.0001).
Univariate analysis
There were 688 cases that showed agreement of breast density category between experienced radiologist and Volpara software.
Remaining 172 cases were categorized in disagreement group.
Table 3 showed the results of univariate analysis about five clinico-radiologic variables between agreement and disagreement groups.
The age and difference in bilateral breast density showed the significant difference between agreement and disagreement groups.
The women in agreement group were younger than women in disagreement group (54.3±9.9 years vs 56.3±11.2 years,
p=0.0191).
The women who have the same bilateral breast density have more agreement than the different bilateral breast density (82.9% vs 17.1%,
p=0.0002).
Whereas,
concerning the indication of mammography (diagnostic or screening groups),
breast density categorized by Volpara software (dense or fatty),
there were no significant differences between agreement and disagreement groups (p=0.7903,
p=0.0990),
respectively.
Multivariate analysis
Multivariate analysis was conducted for the age,
indication of mammography (diagnostic or screenings),
BI-RADS breast density assessed by experienced radiologist,
BI-RADS breast density assessed by Volpara,
difference in bilateral breast density and the BI-RADS final assessment (Table 4).
The difference in bilateral breast density was also independently correlative factor for the more possibility of disagreement with significant difference (Odds ratio(OR)=1.981; 95% CI: 1.322~2.971; p=0.0009).
Among BI-RADS breast density assessed by experienced radiologist,
density category 3 (OR=0.253; 95% CI: 0.091~0.7; p=0.0081) was only significant factor that showed the less possibility of disagreement.
In the case of BI-RADS breast density assessed by Volpara,
VDG 2 (OR=0.496; 95% CI: 0.247~0.993; p=0.0478) and VDG 4 (OR=0.224; 95% CI: 0.07~0.719; p=0.0119) showed the less possibility of disagreement with significant difference.
The age (OR =1.001; 95% CI: 0.979~1.023; p=0.9334) showed the probability of disagreement without significant difference in multivariate analysis,
although it was the significant factor on univariate analysis.
The indication of mammography (OR = 1.228; 95% CI: 0.708~2.13; p=0.4657) and the BI-RADS final assessment (OR = 0.907; 95% CI: 0.53~1.55; p=0.7202) were not significantly associated with disagreement.