Quantification of masking risk in screening mammography with volumetric breast density maps.
Quantification of masking risk in screening mammography with volumetric breast density maps.
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DOI：
10.1007/s10549-017-4137-4
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发表时间：
2017-04
影响因子：
3.8
通讯作者：
Karssemeijer N
中科院分区：
文献类型：
--
作者：
Holland K;van Gils CH;Mann RM;Karssemeijer N
纤维腺组织可能掩盖乳腺癌，从而降低乳房x光检查的敏感性。在这里，我们研究了识别隐匿性肿瘤高风险女性的方法，这些女性可以从额外的影像学检查中获益。研究使用了111名间断性癌症（IC）妇女在检查后12个月内的最后一次阴性乳房x光检查，以及1110名从未患癌症的妇女中选择的正常筛查检查。从乳房x光片中，计算出乳腺体积密度图，它提供了每个像素位置的致密组织厚度。利用这些地图，导出了三个测量值：(1)密度体积百分比（PDV），(2)密度组织厚度超过1厘米的面积百分比（PDA）和(3)密度组织掩蔽模型（DTMM）。乳腺密度由乳腺放射科医生使用BI-RADS评分。异质性和乳房密度极高的女性被认为具有高掩蔽风险。对于每个掩蔽措施，乳房x线照片被分为高风险和低风险类别，以便与BI-RADS相同比例的对照组处于高掩蔽风险。在IC女性中，分别有66.1、71.9、69.2和63.0%被归类为PDV、PDA、DTMM和BI-RADS的高掩蔽风险，而对照组的这一比例为38.5%。BI-RADS与PDA具有高掩蔽风险的IC比例差异有统计学意义（p值为0.022）。BI-RADS与PDV或BI-RADS与DTMM的差异无统计学意义。基于密度图的测量方法，特别是PDA，是很有前途的工具，可用于识别患有隐匿性癌症的高风险妇女。
Fibroglandular tissue may mask breast cancers, thereby reducing the sensitivity of mammography. Here, we investigate methods for identification of women at high risk of a masked tumor, who could benefit from additional imaging. The last negative screening mammograms of 111 women with interval cancer (IC) within 12 months after the examination and 1110 selected normal screening exams from women without cancer were used. From the mammograms, volumetric breast density maps were computed, which provide the dense tissue thickness for each pixel location. With these maps, three measurements were derived: (1) percent dense volume (PDV), (2) percent area where dense tissue thickness exceeds 1 cm (PDA), and (3) dense tissue masking model (DTMM). Breast density was scored by a breast radiologist using BI-RADS. Women with heterogeneously and extremely dense breasts were considered at high masking risk. For each masking measure, mammograms were divided into a high- and low-risk category such that the same proportion of the controls is at high masking risk as with BI-RADS. Of the women with IC, 66.1, 71.9, 69.2, and 63.0% were categorized to be at high masking risk with PDV, PDA, DTMM, and BI-RADS, respectively, against 38.5% of the controls. The proportion of IC at high masking risk is statistically significantly different between BI-RADS and PDA (p-value 0.022). Differences between BI-RADS and PDV, or BI-RADS and DTMM, are not statistically significant. Measures based on density maps, and in particular PDA, are promising tools to identify women at high risk for a masked cancer.