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Quantitative differentiation of benign and malignant mammographic circumscribed masses using intensity histograms

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Abstract

Purpose

To investigate the usefulness of density gradient of mammographic masses for differentiating benign from malignant lesions, particularly circumscribed masses, which are difficult to diagnose by shape.

Materials and methods

Phantom experiments were performed and diagnostic mammography examinations were reviewed. Mammograms of three acrylic resin globes differing in hardness were acquired with/without applied pressure, and density gradients were examined on intensity histograms with standard deviation (SD) as a hardness index. Similar analyses were performed using clinical mammographic examinations of circumscribed mass lesions. The usefulness of SD for differentiating between benign and malignant lesions was investigated by ROC curve analysis and minimum/maximum values of malignant and benign lesions, respectively.

Results

For circumscribed masses (n = 196, benign, n = 176; malignant, n = 20), ROC analysis showed AUC = 0.786, with sensitivity = 70.0 %, specificity = 70.5 %, accuracy = 70.4 %, positive predictive value = 21.1 %, and negative predictive value = 95.4 % at SD = 64.46. Minimum and maximum SD of malignant and benign masses were 39.1 and 241.7, respectively.

Conclusion

On mammography, circumscribed masses can be diagnosed with moderate accuracy using the intensity histogram SD. Masses with SD below the minimum of breast cancer can be roughly diagnosed as clinically benign.

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Acknowledgments

All authors have no relevant financial or nonfinancial relationships to disclose. And Institutional Review Board admitted this study.

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Correspondence to Tomoyuki Ohta.

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Ohta, T., Nakata, N., Nishioka, M. et al. Quantitative differentiation of benign and malignant mammographic circumscribed masses using intensity histograms. Jpn J Radiol 33, 559–565 (2015). https://doi.org/10.1007/s11604-015-0456-8

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  • DOI: https://doi.org/10.1007/s11604-015-0456-8

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