Effect of Training on Qualitative Mammographic Density Assessment |
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| Institution: | 1. Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts;1. Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland;2. Clinical Pharmacokinetics Research Laboratory, Clinical Center, National Institutes of Health, Bethesda, Maryland;3. Translational Neuroradiology Unit, National Institutes of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland;1. Department of Radiology, Division of Cardiovascular Imaging, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts;2. Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts;3. Harvey L. Neiman Health Policy Institute, Reston, Virginia;4. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;1. Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina;2. Rush University Medical Center, Chicago, Illinois;3. Georgetown University Hospital, Washington, District of Columbia, American College of Surgeons;4. Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, Maryland, American Society of Clinical Oncology;5. Interventional Endoscopy and Pancreatic Diseases, New Haven, Connecticut, American Gastroenterological Association;6. University of Illinois Hospital, Chicago, Illinois;7. Massachusetts General Hospital, Boston, Massachusetts;8. University of Colorado, Anschutz Medical Campus, Aurora, Colorado;9. Oregon Health and Science University, Portland, Oregon;10. Riley Hospital for Children, Indianapolis, Indiana;11. University of Wisconsin, Madison, Wisconsin;12. Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois;13. University of Illinois Hospital and Health Science System, Chicago, Illinois;14. Froedtert & the Medical College of Wisconsin, Milwaukee, Wisconsin;1. Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada;2. Division of Infectious Diseases, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada |
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| Abstract: | PurposeThe aim of this study was to evaluate the accuracy of visual mammographic breast density assessment and determine if training can improve this assessment, to compare the accuracy of qualitative density assessment before and after training with a quantitative assessment tool, and to evaluate agreement between qualitative and quantitative density assessment methods.MethodsConsecutive screening mammograms performed over a 4-month period were visually assessed by two study breast radiologists (the leads), who selected 200 cases equally distributed among the four BI-RADS density categories. These 200 cases were shown to 20 other breast radiologists (the readers) before and after viewing a training module on visual density assessment. Agreement between reader assessment and lead radiologist assessment was calculated for both reading sessions. Quantitative volumetric density of the 200 mammograms, determined using a commercially available tool, was compared with both sets of reader assessment and with lead radiologist assessment.ResultsCompared with lead radiologist assessment, reader accuracy of breast density assessment increased from 65% before training to 72% after training (odds ratio, 1.41; P < .0001). Training specifically improved assignment to BI-RADS categories 1 (P < .0001) and 4 (P < .10). Compared with quantitative assessment, reader accuracy showed statistically nonsignificant improvement with training (odds ratio, 1.1; P = .26). Substantial agreement between qualitative and quantitative breast density assessment was demonstrated (κ = 0.78).ConclusionsTraining may improve the accuracy of mammographic breast density assessment. Substantial agreement between qualitative and quantitative breast density assessment exists. |
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| Keywords: | Breast density BI-RADS density mammographic density volumetric breast density breast density legislation |
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