The distribution of the ACR density patterns for first reader was the following:
- In both studies the percentage of patients with ACR a was the same.
- In synthesized-DM there was a decrease of 4.7 % of patients with ACR b and 3.6 % of patients with ACR c.
- However,
there was an increase of 8.3 % of patients with ACR d compared with 2D-DM.
Fig. 2: Results of reader 1.
The intra-observer kappa index for this first reader was 0.809 so substantial or almost perfect agreement was found which was statistically significant (p<0.001).
Fig. 3: Intraobserver kappa index of reader 1.
On the other hand,
the distribution of ACR density patterns for the second reader was as follows:
- In both studies the percentage of patients with ACR a was also the same.
- In this case,
in synthesized-DM we also identified a decrease of patients being 1.5 % in ACR b group and 4.4 % in ACR c group.
- And we also observed an increase,
which in this case was of 5.8 %,
of patients with ACR d compared with 2D-DM.
Fig. 4: Results of reader 2.
The intra-observer kappa index for this second reader was 0.882 so almost perfect agreement was found which was statistically significant (p<0.001).
So both readers noted a trend to increase ACR d density patterns when using synthesized-DM.
Fig. 6: Summary of the results of both readers.
Interobserver concordance for 2D-DM was moderate (kappa index 0.526 (p<0.01)) and slightly better (kappa index 0.553 (p<0.01)) for synthesized-DM and both values were statistically significant (p<0.001).
Fig. 7: Intraobserver kappa indexes.
Cases
Fig. 8: This is a 49 year-old woman with intermediate density in their breasts. We can observe similar density pattern in both techniques.
Fig. 9: This 45 year-old woman has heterogeneous breast density. Slightly higher breast density in the upper and posterior region can be identified, although it is similar in DM and in synthesized-DM.
Fig. 10: In this case we can see a large breast density but similar appearance is observed in both techniques.
Fig. 11: This 39 year-old woman has high breast density. However, similar appearence is observed in both techniques.
Fig. 12: This is a 42 year-old woman with intermediate density in their breasts. In this case, we can see densities slight higher in synthesized-DM, especially in the retroareolar region.
Fig. 13: This other woman also has intermediate breast density. Look how higher breast density can be identified diffusely in synthesized-DM.
Fig. 14: This is a 45 year-old woman with heterogeneous breast density. Look at synthesized-DM, breast’s density seems to be higher.
Fig. 15: This is a particular woman with high breast density. Look at both techniques. In this case we can identify slight higher density in 2D-DM.