Person: Rice, Megan
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Publication Mammographic density assessed on paired raw and processed digital images and on paired screen-film and digital images across three mammography systems
(BioMed Central, 2016) Burton, Anya; Byrnes, Graham; Stone, Jennifer; Tamimi, Rulla; Heine, John; Vachon, Celine; Ozmen, Vahit; Pereira, Ana; Garmendia, Maria Luisa; Scott, Christopher; Hipwell, John H.; Dickens, Caroline; Schüz, Joachim; Aribal, Mustafa Erkin; Bertrand, Kimberly; Kwong, Ava; Giles, Graham G.; Hopper, John; Pérez Gómez, Beatriz; Pollán, Marina; Teo, Soo-Hwang; Mariapun, Shivaani; Taib, Nur Aishah Mohd; Lajous, Martín; Lopez-Riduara, Ruy; Rice, Megan; Romieu, Isabelle; Flugelman, Anath Arzee; Ursin, Giske; Qureshi, Samera; Ma, Huiyan; Lee, Eunjung; Sirous, Reza; Sirous, Mehri; Lee, Jong Won; Kim, Jisun; Salem, Dorria; Kamal, Rasha; Hartman, Mikael; Miao, Hui; Chia, Kee-Seng; Nagata, Chisato; Vinayak, Sudhir; Ndumia, Rose; van Gils, Carla H.; Wanders, Johanna O. P.; Peplonska, Beata; Bukowska, Agnieszka; Allen, Steve; Vinnicombe, Sarah; Moss, Sue; Chiarelli, Anna M.; Linton, Linda; Maskarinec, Gertraud; Yaffe, Martin J.; Boyd, Norman F.; dos-Santos-Silva, Isabel; McCormack, Valerie A.Background: Inter-women and intra-women comparisons of mammographic density (MD) are needed in research, clinical and screening applications; however, MD measurements are influenced by mammography modality (screen film/digital) and digital image format (raw/processed). We aimed to examine differences in MD assessed on these image types. Methods: We obtained 1294 pairs of images saved in both raw and processed formats from Hologic and General Electric (GE) direct digital systems and a Fuji computed radiography (CR) system, and 128 screen-film and processed CR-digital pairs from consecutive screening rounds. Four readers performed Cumulus-based MD measurements (n = 3441), with each image pair read by the same reader. Multi-level models of square-root percent MD were fitted, with a random intercept for woman, to estimate processed–raw MD differences. Results: Breast area did not differ in processed images compared with that in raw images, but the percent MD was higher, due to a larger dense area (median 28.5 and 25.4 cm2 respectively, mean √dense area difference 0.44 cm (95% CI: 0.36, 0.52)). This difference in √dense area was significant for direct digital systems (Hologic 0.50 cm (95% CI: 0.39, 0.61), GE 0.56 cm (95% CI: 0.42, 0.69)) but not for Fuji CR (0.06 cm (95% CI: −0.10, 0.23)). Additionally, within each system, reader-specific differences varied in magnitude and direction (p < 0.001). Conversion equations revealed differences converged to zero with increasing dense area. MD differences between screen-film and processed digital on the subsequent screening round were consistent with expected time-related MD declines. Conclusions: MD was slightly higher when measured on processed than on raw direct digital mammograms. Comparisons of MD on these image formats should ideally control for this non-constant and reader-specific difference. Electronic supplementary material The online version of this article (doi:10.1186/s13058-016-0787-0) contains supplementary material, which is available to authorized users.