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. 2006 Sep;19(3):258-63.
doi: 10.1007/s10278-006-0592-x.

Impact of breast density on computer-aided detection in full-field digital mammography

Silvia Obenauer  1 , Christian Sohns, Carola Werner, Eckhardt Grabbe
Affiliations

Impact of breast density on computer-aided detection in full-field digital mammography

Silvia Obenauer et al. J Digit Imaging. 2006 Sep.

Abstract

The goal of this study was to evaluate the performance of a computer-aided detection (CAD) system in full-field digital mammography (Senographe 2000D, General Electric, Buc, France) in finding out carcinomas depending on the parenchymal density. A total of 226 mediolateral oblique (MLO) and 186 craniocaudal (CC) mammographic views of histologically proven cancers were retrospectively evaluated with a digital CAD system (ImageChecker V2.3 R2 Technology, Los Altos, CA, USA). Malignant tumors were detected correctly by CAD in MLO view in 84.85% in breasts with parenchymal tissue density of the American College of Radiology (ACR) type 1, in 70.33% of the ACR type 2, in 68.12% of the ACR type 3, and in 69.70% of the ACR type 4. For the CC view, similar results were found according to the ACR types. Using the chi-square and McNemar tests, there was no statistical significance. However, a trend of better detection could be seen with decreasing ACR type. In conclusion, there seems to be a tendency for breast tissue density to affect the detection rate of breast cancer when using the CAD system.

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Figures

Fig 1
Fig 1
True positive marker in CC view (a); no marker in MLO view (b). Mass near the thoracic wall.
Fig 2
Fig 2
True-positive and false-positive CAD markers in different breast tissue types. (a, b) Breast cancer with true positive markers for the microcalcifications (∇) and the mass (*) of the tumor in the upper quadrant of the breast in MLO (a) and CC (b) view in a fatty-type breast (ACR type 1). False-positive marker in the middle of the breast (vessel calcification) in MLO view. (c, d) Mass in a fibroglandular breast tissue (ACR type 2) with true positive marker in MLO (c) and CC view (d). (e, f) True positive markers in a breast with heterogeneously dense breast tissue (ACR type 3) with a bifocal mass in MLO view (e). Only one marker in CC view (f). (g, h) True positive markers of a cancer with diffuse pleomorphic microcalcifications in an extremely dense breast (ACR type 4).
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