Breast Density: Comparison of Chest CT with Mammography

Mastrangelo, Salvatore; Margolies, Laurie; Kale, Minal; Wisnivesky, Juan P.; Kotkin, Sean; Henschke, Claudia I.; Yankelevitz, David F.

doi:10.1148/radiology.13130733

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…In a previous study, chest CT mography and breast composition on chest CT might provide additional information for predicting risk of breast cancers (5).…”

Section: Introductionmentioning

confidence: 93%

Detection of Breast Abnormalities on Enhanced Chest CT: Correlation with Breast Composition on Mammography

Cho

Kang

Shin

et al. 2017

J Korean Soc Radiol

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Purpose:To investigate the capability of enhanced chest computed tomography (CT) for detecting breast abnormalities and to assess the influence of breast composition on this detectability. Materials and Methods: From 2000 to 2013, 75 patients who underwent mammography, breast sonography, and enhanced chest CT within one month and had abnormalities on sonography were included. Detection rate of breast abnormality on enhanced chest CT was compared among 4 types of breast composition by the Breast Imaging Reporting and Data System. Contribution of breast composition, size and enhancement of target lesions to detectability of enhanced chest CT was assessed using logistic regression and chi-square test. Results: Of the 75 target lesions, 34 (45.3%) were detected on enhanced chest CT, corresponding with those on breast sonography; there were no significantly different detection rates among the 4 types of breast composition (p = 0.078). Breast composition [odds ratio (OR) = 1.07, p = 0.206] and enhancement (OR = 21.49, p = 0.998) had no significant effect, but size (OR = 1.23, p = 0.004) was a significant contributing factor influencing the detectability of enhanced chest CT for breast lesions. Conclusion: About half of the cases (45.3%) demonstrated breast lesions on chest CT corresponding with target lesions on sonography. Breast composition defined on mammography did not affect the detectability of enhanced chest CT for breast lesions. Index termsBreast Chest Multidetector Computed Tomography Ultrasound Mammography

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“…In a previous study, chest CT mography and breast composition on chest CT might provide additional information for predicting risk of breast cancers (5).…”

Section: Introductionmentioning

confidence: 93%

Detection of Breast Abnormalities on Enhanced Chest CT: Correlation with Breast Composition on Mammography

Cho

Kang

Shin

et al. 2017

J Korean Soc Radiol

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“…An improved understanding of the visual assessment processes used by radiologists can help to discover the possible reasons behind MD reporting inconsistencies that are widely found within the literature [12][13][14][15][16][17][18][19][20]. Although radiologists within clinical practice only visually assess MD, they do have their own opinions regarding what kinds of tissue appearance should be regarded as MD.…”

Section: Discussionmentioning

confidence: 99%

“…However, studies investigating the consistency of radiologist MD reporting only show moderate inter-reader agreement [12][13][14][15][16][17][18][19][20]. Computer-aided methods to measure MD are currently developed [21][22][23][24] but to date are not widely used clinically, as they still require robust validation [14,25].…”

Section: Introductionmentioning

confidence: 99%

An Investigation into the Consistency in Mammographic Density Identification by Radiologists: Effect of Radiologist Expertise and Mammographic Appearance

Brennan

Lee

et al. 2015

J Digit Imaging

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The aim of this work is to investigate how radiologist expertise and image appearance may have an impact on inter-reader variability of mammographic density (MD) identification. Seventeen radiologists, divided into three expertise groups, were asked to manually segment the areas they consider to be MD in 40 clinical images. The variation in identification of MD for each image was quantified by finding the range of segmentation areas. The impact of radiologist expertise and image appearance on this variation was explored. The range of areas chosen by participating radiologists varied from 7 to 73 % across the 40 images, with a mean range of 35± 13 %. Participants with high expertise were more likely to choose similar areas to one another, compared to participants with medium and low expertise levels (mean range were 19± 10 %, 29±13 % and 25±14 %, respectively, p<0.0001). There was a significantly higher average grey level for the area segmented by all radiologists as MD compared to the area of variation, with mean grey level value for 8-bit images being 146±19 vs. 99±14, respectively. MD segmentation borders were consistent in areas where there was a sharp intensity change within a short distance. In conclusion, radiologists with high expertise tend to have a higher agreement when identifying MD. Tissues which have a lower contrast and a less visually sharp gradient change at the interface between high density tissue and adipose background lead to interreader variation in choosing mammographic density.

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“…Grade 1: breasts are almost entirely fatty; grade 2: breasts are composed of scattered fibroglandular densities; grade 3: breasts are heterogeneously dense, which may obscure small masses, and grade 4: breasts are extremely dense, which lowers the sensitivity of mammography. The key differentiation is between grades 1-2 and 3-4 (57). If the percentage of breast tissue is, grade 3 or grade 4, then this should be noted in the report as it suggests an increased risk for breast cancer and if clinically indicated, ultrasound or MRI of the breast is suggested as the mammogram might obscure an early cancer or precursor lesion.…”

Section: Other Findings On the Ct Scanmentioning

confidence: 99%

The importance of the regimen of screening in maximizing the benefit and minimizing the harms

Henschke¹,

Li²,

Yip³

et al. 2016

Ann. Transl. Med.

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Background: In CT screening for lung cancer, the regimen of screening is critical in diagnosing lung cancer early while limiting unnecessary tests and invasive procedures. The International Early Lung Cancer Action Program (I-ELCAP) has developed a regimen based on evidence collected in the I-ELCAP cohort of more than 70,000 participants.Methods: Important in the development of the regimen is the recognition of the profound difference between the first, baseline round of screening and all subsequent rounds of repeat screening. For each person undergoing screening, the baseline round happens only once while repeat rounds will be performed annually for many years.This difference needs to be clearly recognized as it is these annual rounds which allow for identification of small, early, yet aggressive, lung cancers which have high cure rates despite their aggressiveness. The importance of nodule consistency and size are key factors in the regimen. The regimen needs to be continuously updated by incorporating advances in technology and knowledge.Results: The use of the I-ELCAP regimen reduces the workup of participants in the screening program to less than 10% in the baseline round and less than 6% in the annual repeat rounds. By use of this regimen, estimated cure rate of lung cancers diagnosed under screening is 80% or higher in both baseline and annual repeat rounds. Conclusions:The I-ELCAP collaboration provides a new paradigm that answers the 2002 NCI call for multiple approaches to address relevant questions about screening and the Institute of Medicine (IOM) Roundtable on Evidence-based Medicine from the National Academy of Science's call for a "new clinical research paradigm that takes better advantage of data generated in the course of healthcare delivery would speed and improve the development of evidence for real-world decision making".

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Breast Density: Comparison of Chest CT with Mammography

Cited by 3 publications

References 16 publications

Detection of Breast Abnormalities on Enhanced Chest CT: Correlation with Breast Composition on Mammography

Detection of Breast Abnormalities on Enhanced Chest CT: Correlation with Breast Composition on Mammography

An Investigation into the Consistency in Mammographic Density Identification by Radiologists: Effect of Radiologist Expertise and Mammographic Appearance

The importance of the regimen of screening in maximizing the benefit and minimizing the harms

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