Objectives: To compare breast density (BD) assessment provided by an automated BD evaluator (ABDE) with that provided by a panel of experienced breast radiologists, on a multivendor dataset. Methods: Twenty-one radiologists assessed 613 screening/diagnostic digital mammograms from 9 centers and 6 different vendors, using the BI-RADS a, b, c, and d density classification. The same mammograms were also evaluated by an ABDE providing the ratio between fibroglandular and total breast area on a continuous scale and, automatically, the BI-RADS score. Panel majority report (PMR) was used as reference standard. Agreement (k) and accuracy (proportion of cases correctly classified) were calculated for binary (BI-RADS a-b versus c-d) and 4-class classification. Results: While the agreement of individual radiologists with PMR ranged from k=0.483 to k=0.885, the ABDE correctly classified 563/613 mammograms (92%). A substantial agreement for binary classification was found for individual reader pairs (k=0.620, standard deviation [SD]=0.140), individual versus PMR (k=0.736, SD=0.117), and individual versus ABDE (k=0.674, SD=0.095). Agreement between ABDE and PMR was almost perfect (k=0.831). Conclusions: The ABDE showed an almost perfect agreement with a 21-radiologist panel in binary BD classification on a multivendor dataset, earning a chance as a reproducible alternative to visual evaluation.
@article{arxiv.1811.05324,
title = {Mammographic density: Comparison of visual assessment with fully automatic calculation on a multivendor dataset},
author = {Daniela Sacchetto and Lia Morra and Silvano Agliozzo and Daniela Bernardi and Tomas Bjorklund and Beniamino Brancato and Patrizia Bravetti and Luca A. Carbonaro and Loredana Correale and Carmen Fantò and Elisabetta Favettini and Laura Martincich and Luisella Milanesio and Sara Mombelloni and Francesco Monetti and Doralba Morrone and Marco Pellegrini and Barbara Pesce and Antonella Petrillo and Gianni Saguatti and Carmen Stevanin and Rubina M. Trimboli and Paola Tuttobene and Marvi Valentini and Vincenzo Marra and Alfonso Frigerio and Alberto Bert and Francesco Sardanelli},
journal= {arXiv preprint arXiv:1811.05324},
year = {2019}
}