Reproducibility of visual assessment on mammographic density
Reproducibility of visual assessment on mammographic density
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DOI：
10.1007/s10549-007-9581-0
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发表时间：
2008-03-01
影响因子：
3.8
通讯作者：
Forbes, John F.
中科院分区：
文献类型：
--
作者：
Gao, Jinnan;Warren, Ruth;Forbes, John F.
背景高密度钼靶摄影是乳腺癌的独立危险因素，与大多数其他已知危险因素相比具有更高的相关风险。重复性仍然是评估乳腺实质模式的一个主要问题。乳房X光检查模式的错误分类可能导致对风险估计的严重低估。本研究的目的是评估基于视觉主观乳腺摄影密度测量的评分员间和评分员内的可靠性。方法对Wolfe实质分型、Boyd分级和全乳腺密度百分比三种密度测量方法进行了研究。这项研究包括101名参与国际乳腺癌干预研究I(IBIS I)长达7年的女性。为每名妇女收集了七套乳房X光照片。左乳房内侧斜位片数字化，扫描图像由两位读者独立审阅。一位读者在一年后对这些图片进行了重新评估。结果评分者间一致性的加权Kappa值分别为0.89(P<；0.0001)和0.84(P<；0.0001)。百分比密度的类内相关系数为0.94。对于评价者内部一致性，Wolfe量表的加权Kappa为0.87%(P<；0.0001)，Boyd量表的加权Kappa为0.86%(P<；0.0001)。组内相关系数为0.96。结论只要训练得当，对乳腺X线密度的视觉定性和定量测量都具有很高的重复性。该方法适用于预防试验进入前的风险评估。
Background High mammographic density was an independent risk factor for breast cancer and has a higher associated risk than most other known risk factors. The reproducibility remains a major issue in assessment of breast parenchymal patterns. Misclassification of mammographic pattern can lead to significant underestimation of risk estimates. The purpose of this study was to assess the inter-rater and intra-rater reliability based on visual subjective mammographic density measurements.Method Three density measures, Wolfe parenchymal pattern, Boyd classification scale, and a percentage of densities in total breast, were investigated. The study included 101 women who were participants of the International Breast Cancer Intervention Study I (IBIS I) for up to 7 years. Seven sets of mammograms were collected for each woman. Left breast mediolateral oblique films were digitized, and the scanned images were independently reviewed by two readers. These images were reassessed by one reader after a year. The agreements of measures were evaluated by Kappa statistics (Wolfe and Boyd scale) and intraclass correlation coefficient (percentage densities).Results For the inter-rater agreement, Weighted Kappa for Wolfe scale was 0.89 (P < 0.0001) and for Boyd scale was 0.84 (P < 0.0001). The intraclass correlation coefficient was 0.94 for percentage densities. For the intra-rater agreement, Weighted Kappa for Wolfe scale was 0.87 (P < 0.0001) and for Boyd scale was 0.86 (P < 0.0001). The intraclass correlation coefficient was 0.96 for percentage densities.Conclusion We conclude that both visual qualitative and quantitative measurements on mammographic density are highly reproducible if appropriate training is provided. The method is appropriate for risk assessment prior to entry in a prevention trial.