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Mammographic density estimation: one-to-one comparison of digital mammography and digital breast tomosynthesis using fully automated software

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Abstract

Objective

To compare breast density on digital mammography and digital breast tomosynthesis using fully automated software.

Methods

Following institutional approval and written informed consent from all participating women, both digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) were obtained. Breast percentage density was calculated with software on DBT and FFDM.

Results

Fifty consecutive patients (mean age, 51 years; range, 35–83 years) underwent both FFDM and DBT. Using a method based on the integral curve, breast density showed higher results on FFDM (68.1 ± 12.1 for FFDM and 51.9 ± 6.5 for DBT). FFDM overestimated breast density in 16.2% (P < 0.0001). Using a method based on maximum entropy thresholding, breast density showed higher results on FFDM (68.1 ± 12.1 for FFDM and 51.9 ± 6.5 for DBT). FFDM overestimated breast density in 11.4% (P < 0.0001). There was a good correlation among BI-RADS categories on a four-grade scale and the density evaluated with DBT and FFDM (r = 0.54, P < 0.01 and r = 0.44, P < 0.01).

Conclusion

Breast density appeared to be significantly underestimated on digital breast tomosynthesis.

Key Points

  • Breast density is considered to be an independent risk factor for cancer

  • Density can be assessed on full-field digital mammography and digital breast tomosynthesis

  • Objective automated estimation of breast density eliminates subjectivity

  • Automated estimation is more accurate than BI-RADS quantitative evaluation

  • Breast density may be significantly underestimated on digital breast tomosynthesis

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Authors and Affiliations

  1. Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Largo Rosanna Benzi 8, 16132, Genoa, Italy

    Alberto Tagliafico

  2. Dipartimento di Chimica e Chimica Industriale (DCCI), University of Genoa, via Dodecaneso 31, 16146, Genoa, Italy

    Giulio Tagliafico

  3. Radiology Department, University of Genoa, Largo Rosanna Benzi 8, 16138, Genoa, Genova, Italy

    Davide Astengo

  4. Department of Medical Physics, Ist Istituto Nazionale per la Ricerca sul Cancro, IRCCS Azienda Ospedaliera Universitaria San Martino, Largo Rosanna Benzi 10, 16138, Genoa, Genova, Italy

    Francesca Cavagnetto & Raffaella Rosasco

  5. Department of Diagnostic Senology, Ist Istituto Nazionale per la Ricerca sul Cancro, IRCCS Azienda Ospedaliera Universitaria San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy

    Giuseppe Rescinito, Francesco Monetti & Massimo Calabrese

Authors
  1. Alberto Tagliafico
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  2. Giulio Tagliafico
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  3. Davide Astengo
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  4. Francesca Cavagnetto
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  7. Francesco Monetti
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  8. Massimo Calabrese
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Correspondence to Alberto Tagliafico.

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Tagliafico, A., Tagliafico, G., Astengo, D. et al. Mammographic density estimation: one-to-one comparison of digital mammography and digital breast tomosynthesis using fully automated software. Eur Radiol 22, 1265–1270 (2012). https://doi.org/10.1007/s00330-012-2380-y

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  • DOI: https://doi.org/10.1007/s00330-012-2380-y

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