Mammographic density assessed on paired raw and processed digital images and on paired screen-film and digital images across three mammography systems.

Burton, A; Byrnes, G; Stone, J; Tamimi, RM; Heine, J; Vachon, C; Ozmen, V; Pereira, A; Garmendia, ML; Scott, C; Hipwell, JH; Dickens, C; Schüz, J; Aribal, ME; Bertrand, K; Kwong, A; Giles, GG; Hopper, J; Pérez Gómez, B; Pollán, M; Teo, SH; Mariapun, S; Taib, NA; Lajous, M; Lopez-Riduara, R; Rice, M; Romieu, I; Flugelman, AA; Ursin, G; Qureshi, S; Ma, H; Lee, E; Sirous, R; Sirous, M; Lee, JW; Kim, J; Salem, D; Kamal, R; Hartman, M; Miao, H; Chia, KS; Nagata, C; Vinayak, S; Ndumia, R; van Gils, CH; Wanders, JO; Peplonska, B; Bukowska, A; Allen, S; Vinnicombe, S; Moss, S; Chiarelli, AM; Linton, L; Maskarinec, G; Yaffe, MJ; Boyd, NF; Dos-Santos-Silva, I; McCormack, VA; (2016) Mammographic density assessed on paired raw and processed digital images and on paired screen-film and digital images across three mammography systems. Breast cancer research, 18 (1). p. 130. ISSN 1465-5411 DOI:

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Inter-women and intra-women comparisons of mammographic density (MD) are needed in research, clinical and screening applications; however, MD measurements are influenced by mammography modality (screen film/digital) and digital image format (raw/processed). We aimed to examine differences in MD assessed on these image types. We obtained 1294 pairs of images saved in both raw and processed formats from Hologic and General Electric (GE) direct digital systems and a Fuji computed radiography (CR) system, and 128 screen-film and processed CR-digital pairs from consecutive screening rounds. Four readers performed Cumulus-based MD measurements (n = 3441), with each image pair read by the same reader. Multi-level models of square-root percent MD were fitted, with a random intercept for woman, to estimate processed-raw MD differences. Breast area did not differ in processed images compared with that in raw images, but the percent MD was higher, due to a larger dense area (median 28.5 and 25.4 cm(2) respectively, mean √dense area difference 0.44 cm (95% CI: 0.36, 0.52)). This difference in √dense area was significant for direct digital systems (Hologic 0.50 cm (95% CI: 0.39, 0.61), GE 0.56 cm (95% CI: 0.42, 0.69)) but not for Fuji CR (0.06 cm (95% CI: -0.10, 0.23)). Additionally, within each system, reader-specific differences varied in magnitude and direction (p < 0.001). Conversion equations revealed differences converged to zero with increasing dense area. MD differences between screen-film and processed digital on the subsequent screening round were consistent with expected time-related MD declines. MD was slightly higher when measured on processed than on raw direct digital mammograms. Comparisons of MD on these image formats should ideally control for this non-constant and reader-specific difference.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
PubMed ID: 27993168
Web of Science ID: 391503900002


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