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Table 2 Comparison between mammographic density assessment using different visual scales (1 rater), DM-Scan (3 raters) and Cumulus (1 rater)

From: Validation of DM-Scan, a computer-assisted tool to assess mammographic density in full-field digital mammograms

  

DM-Scan Rater 1

DM-Scan Rater 2

DM-Scan Rater 3

Cumulus (Rater 1)

Classification

N

Mean

P05-P95

Mean

P05-P95

Mean

P05-P95

Mean

P05-P95

Qualitative scales

        

Wolfea

         

N1

43

1.8%

0.0%-5.8%

3.6%

0.0%-12.5%

1.6%

0.0%-6.5%

2.3%

0.0%-6.5%

P1

327

8.2%

0.0%-19.2%

10.4%

1.5%-24.8%

7.9%

0.0%-17.1%

5.4%

0.0%-17.1%

P2

166

25.6%

12.3%-1.3%

26.7%

11.7%-45.8%

25.7%

5.7%-38.7%

19.3%

5.7%-38.7%

DY

101

33.5%

15.2%-55.7%

34.1%

13.8%-60.1%

32.7%

9.3%-61.4%

29.2%

9.3%-61.4%

Tabarb

         

II

43

1.8%

0.0%-5.8%

3.6%

0.0%-12.5%

1.6%

0.0%-6.5%

2.3%

0.0%-6.5%

III

381

10.1%

0.0%-26.0%

12.2%

1.7%-12.5%

9.8%

1.1%-23.2%

6.8%

0.1%-22.6%

IV

155

30.8%

13.4%-53.2%

31.5%

12.3%-54.7%

30.6%

13.0%-50.5%

24.9%

5.9%-50.9%

V

58

29.4%

12.8%-51.6%

29.8%

10.4%-52.5%

28.7%

12.3%-53.8%

25.6%

9.4%-51.4%

BIRADS densityc

         

1

340

6.8%

0.0%-17.5%

8.8%

0.4%-21.5%

6.5%

0.0%-15.8%

4.6%

0.0%-13.9%

2

183

21.2%

10.8%-36.6%

21.9%

10.1%-38.3%

20.8%

10.2%-34.6%

15.4%

4.2%-30.6%

3

89

34.1%

24.0%-48.3%

35.4%

22.3%-50.4%

33.9%

21.8%-49.2%

28.2%

15.4%-46.6%

4

25

47.6%

30.9%-68.0%

51.3%

32.0%-69.4%

47.6%

32.5%-61.8%

45.4%

16.8%-68.3%

Semiquantitative scale

        

Boyd categories

         

0%

46

1.0%

0.0%-5.3%

2.1%

0.0%-8.7%

1.1%

0.0%-3.8%

1.6%

0.0%-5.8%

<10%

186

5.7%

0.0%-14.3%

7.1%

1.5%-14.5%

5.3%

0.8%-12.3%

3.4%

0.0%-8.2%

10%-25%

195

14.1%

3.8%-27.1%

16.0%

7.0%-28.8%

13.6%

5.1%-23.5%

9.2%

2.4%-20.4%

25-50%

139

26.2%

13.6%-40.2%

27.6%

14.9%-44.1%

26.2%

12.5%-41.5%

21.4%

7.3%-37.4%

50-75%

59

37.5%

28.2%-48.8%

39.5%

27.5%-51.1%

38.0%

26.1%-53.4%

31.4%

0.5%-47.9%

>75%

13

56.0%

41.3%-71.7%

57.0%

46.8%-69.4%

51.6%

40.3%-61.8%

55.0%

44.2%-77.2%

Agreement Boyd – DM-Scan

     

Agreement Boyd –Cumulus

Weighted kappa

 

0.801

 

0.789

 

0.805

 

0.697

(95% Confidence Interval)

 

(0.777-0.823)

 

(0.764-.812)

 

(0.783-.825)

 

(0.652-.738)

Agreement Cumulus – DM-Scan

       

Mean Difference (DM-Scan – Cumulus)

Mean Difference

CCC e

Mean Difference

CCC e

Mean Difference

CCC

  

(P05-P95d)

+3.7%

0.841

+5.3%

0.803

+3.5%

0.842

Concordance Correlation Coefficient (CCC)

(+0.0% to +42.3%)

(0.820-0.863)

(+1.3% to+45.6%)

(0.777-0.828)

(+0.8% to +43.3%)

(0.820-0.864)

(95% Confidence Interval)

  1. a Wolfe classification:
  2. N1: Breast composed almost completely of fat, with perhaps just a few fibrous connective tissue strands.
  3. P1: Breast composed mainly of fat, although up to a quarter of the sub-areolar area may show beaded or cord-like areas of ducts.
  4. P2: More severe involvement of the breast, with a prominent duct pattern occupying more than one quarter of breast volume.
  5. DY: Breast typically contains extensive regions of homogeneous mammographic densities. The proportion of density is greater than that of the fat.
  6. b Tabár classification:
  7. I Mammogram composed of scalloped contours with some lucent areas of fatty replacement and 1 mm evenly distributed nodular densities (none of our mammograms were classified in this category).
  8. II Mammogram composed almost entirely of lucent areas of fatty replacement and 1-mm evenly distributed nodular densities.
  9. III: Prominent ducts in the retroareolar area.
  10. IV: Extensive, nodular and linear densities with nodular size larger than normal lobules.
  11. V: Homogeneous ground-glass-like appearance with no perceptible features.
  12. c Breast Imaging Reporting and Data System (BIRADS) classification:
  13. 1 Predominantly fatti breast.
  14. 2 Scattered fibroglandular densities.
  15. 3 Heterogeneously dense breast.
  16. 4 Extremely dense breast.
  17. d 5th & 95th percentiles of the differences between PD estimated with DM-Scan and Cumulus.
  18. e Concordance correlation coefficient and its 95% Con.