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

Burton, AORCID logo; Byrnes, G; Stone, J; Tamimi, RM; Heine, J; Vachon, C; Ozmen, V; Pereira, A; Garmendia, ML; Scott, C; +48 more...Hipwell, JH; Dickens, C; Schüz, J; Aribal, ME; Bertrand, K; Kwong, A; Giles, GG; Hopper, J; Pérez Gómez, B; Pollán, M; Teo, S; Mariapun, S; Taib, NAM; 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, K; 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, IORCID logo; McCormack, VA and (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). 130-. ISSN 1465-5411 DOI: 10.1186/s13058-016-0787-0
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BACKGROUND: 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. METHODS: 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. RESULTS: 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 cm2 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. CONCLUSIONS: 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.


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