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Radiological assessment of breast density by visual classification (BI–RADS) compared to automated volumetric digital software (Quantra): implications for clinical practice

  • Breast Radiology
  • Published:
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Abstract

Objective

This study was done to assess breast density on digital mammography and digital breast tomosynthesis according to the visual Breast Imaging Reporting and Data System (BI–RADS) classification, to compare visual assessment with Quantra software for automated density measurement, and to establish the role of the software in clinical practice.

Materials and methods

We analysed 200 digital mammograms performed in 2D and 3D modality, 100 of which positive for breast cancer and 100 negative. Radiological density was assessed with the BI–RADS classification; a Quantra density cut-off value was sought on the 2D images only to discriminate between BI–RADS categories 1–2 and BI–RADS 3–4. Breast density was correlated with age, use of hormone therapy, and increased risk of disease.

Results

The agreement between the 2D and 3D assessments of BI–RADS density was high (K 0.96). A cut-off value of 21 % is that which allows us to best discriminate between BI–RADS categories 1–2 and 3–4. Breast density was negatively correlated to age (r =  −0.44) and positively to use of hormone therapy (p = 0.0004). Quantra density was higher in breasts with cancer than in healthy breasts.

Conclusions

There is no clear difference between the visual assessments of density on 2D and 3D images. Use of the automated system requires the adoption of a cut-off value (set at 21 %) to effectively discriminate BI–RADS 1–2 and 3–4, and could be useful in clinical practice.

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Conflict of interest

E Regini, G. Mariscotti, M. Durando, G. Ghione, A. Luparia, P.P. Campanino, C.C. Bianchi, L. Bergamasco, P. Fonio, G. Gandini declare that they have no conflict of interest related with the publication of this manuscript.

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Authors and Affiliations

  1. S.C. Radiologia Universitaria, Università di Torino, Dipartimento di Diagnostica per Immagini e Radioterapia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Turin, Italy

    Elisa Regini, Giovanna Mariscotti, Manuela Durando, Gianluca Ghione, Caterina Chiara Bianchi, Paolo Fonio & Giovanni Gandini

  2. Service d’Imagerie Médicale, Centre Hospitalier Universitaire Brugmann, Place Van Gehuchten 4, 1020, Bruxelles, Belgium

    Andrea Luparia

  3. Servizio di Diagnostica Clinica Senologica, Ospedale Koelliker, C.so Galileo Ferraris 256, Turin, Italy

    Pier Paolo Campanino

  4. Dipartimento di Scienze Chirurgiche, Azienda Ospedaliera Città della Salute e della Scienza di Torino Presidio Molinette, Università di Torino, Corso Bramante 88, 10126, Turin, Italy

    Laura Bergamasco

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  1. Elisa Regini
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  2. Giovanna Mariscotti
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  3. Manuela Durando
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  7. Caterina Chiara Bianchi
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  8. Laura Bergamasco
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  9. Paolo Fonio
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  10. Giovanni Gandini
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Correspondence to Elisa Regini.

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Regini, E., Mariscotti, G., Durando, M. et al. Radiological assessment of breast density by visual classification (BI–RADS) compared to automated volumetric digital software (Quantra): implications for clinical practice. Radiol med 119, 741–749 (2014). https://doi.org/10.1007/s11547-014-0390-3

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  • DOI: https://doi.org/10.1007/s11547-014-0390-3

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