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Proceedings Paper

A stepwedge-based method for measuring breast density: observer variability and comparison with human reading
Author(s): Jenny Diffey; Michael Berks; Alan Hufton; Camilla Chung; Rosanne Verow; Joanna Morrison; Mary Wilson; Caroline Boggis; Julie Morris; Anthony Maxwell; Susan Astley
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Paper Abstract

Breast density is positively linked to the risk of developing breast cancer. We have developed a semi-automated, stepwedge-based method that has been applied to the mammograms of 1,289 women in the UK breast screening programme to measure breast density by volume and area. 116 images were analysed by three independent operators to assess inter-observer variability; 24 of these were analysed on 10 separate occasions by the same operator to determine intra-observer variability. 168 separate images were analysed using the stepwedge method and by two radiologists who independently estimated percentage breast density by area. There was little intra-observer variability in the stepwedge method (average coefficients of variation 3.49% - 5.73%). There were significant differences in the volumes of glandular tissue obtained by the three operators. This was attributed to variations in the operators' definition of the breast edge. For fatty and dense breasts, there was good correlation between breast density assessed by the stepwedge method and the radiologists. This was also observed between radiologists, despite significant inter-observer variation. Based on analysis of thresholds used in the stepwedge method, radiologists' definition of a dense pixel is one in which the percentage of glandular tissue is between 10 and 20% of the total thickness of tissue.

Paper Details

Date Published: 19 March 2010
PDF: 8 pages
Proc. SPIE 7622, Medical Imaging 2010: Physics of Medical Imaging, 76220A (19 March 2010); doi: 10.1117/12.844265
Show Author Affiliations
Jenny Diffey, The Univ. of Manchester (United Kingdom)
The Christie NHS Foundation Trust (United Kingdom)
Michael Berks, The Univ. of Manchester (United Kingdom)
Alan Hufton, The Christie NHS Foundation Trust (United Kingdom)
Camilla Chung, The Univ. of Manchester (United Kingdom)
Rosanne Verow, The Univ. of Manchester (United Kingdom)
Joanna Morrison, The Univ. of Manchester (United Kingdom)
Mary Wilson, Univ. Hospital of South Manchester NHS Foundation Trust (United Kingdom)
Caroline Boggis, Univ. Hospital of South Manchester NHS Foundation Trust (United Kingdom)
Julie Morris, Univ. Hospital of South Manchester NHS Foundation Trust (United Kingdom)
Anthony Maxwell, Royal Bolton Hospital (United Kingdom)
Susan Astley, The Univ. of Manchester (United Kingdom)


Published in SPIE Proceedings Vol. 7622:
Medical Imaging 2010: Physics of Medical Imaging
Ehsan Samei; Norbert J. Pelc, Editor(s)

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