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Comparative Study
. 2008 Sep;17(9):2268-74.
doi: 10.1158/1055-9965.EPI-07-2547.

A pilot study of compositional analysis of the breast and estimation of breast mammographic density using three-dimensional T1-weighted magnetic resonance imaging

Michael Khazen  1 , Ruth M L Warren, Caroline R M Boggis, Emilie C Bryant, Sadie Reed, Iqbal Warsi, Linda J Pointon, Gek E Kwan-Lim, Deborah Thompson, Ros Eeles, Doug Easton, D Gareth Evans, Martin O Leach; Collaborators in the United Kingdom Medical Research Council Magnetic Resonance Imaging in Breast Screening (MARIBS) Study
Affiliations
Comparative Study

A pilot study of compositional analysis of the breast and estimation of breast mammographic density using three-dimensional T1-weighted magnetic resonance imaging

Michael Khazen et al. Cancer Epidemiol Biomarkers Prev. 2008 Sep.

Abstract

Purpose: A method and computer tool to estimate percentage magnetic resonance (MR) imaging (MRI) breast density using three-dimensional T(1)-weighted MRI is introduced, and compared with mammographic percentage density [X-ray mammography (XRM)].

Materials and methods: Ethical approval and informed consent were obtained. A method to assess MRI breast density as percentage volume occupied by water-containing tissue on three-dimensional T(1)-weighted MR images is described and applied in a pilot study to 138 subjects who were imaged by both MRI and XRM during the Magnetic Resonance Imaging in Breast Screening study. For comparison, percentage mammographic density was measured from matching XRMs as a ratio of dense to total projection areas scored visually using a 21-point score and measured by applying a two-dimensional interactive program (CUMULUS). The MRI and XRM percent methods were compared, including assessment of left-right and interreader consistency.

Results: Percent MRI density correlated strongly (r = 0.78; P < 0.0001) with percent mammographic density estimated using Cumulus. Comparison with visual assessment also showed a strong correlation. The mammographic methods overestimate density compared with MRI volumetric assessment by a factor approaching 2.

Discussion: MRI provides direct three-dimensional measurement of the proportion of water-based tissue in the breast. It correlates well with visual and computerized percent mammographic density measurements. This method may have direct application in women having breast cancer screening by breast MRI and may aid in determination of risk.

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Figures

Text Fig. 1
Text Fig. 1
General view of the Mammographic density analysis tool
Text. Fig 2
Text. Fig 2
Relationship between percent density measured on MRI and percent density measured on XRM (CUMULUS technique), based on 264 breasts from 137 women in the pilot study for whom both measures were available. Slope=0.56 (95% CI = 0.48-0.63), p<0.001.
Text Fig. 3
Text Fig. 3
Bland-Altman plots of the consistency of the percent density estimates for (a) left/right side consistency of MRI-based estimates (137 women) (b) left/right side consistency of XRM CUMULUS estimates (132 women) (c) inter-reader agreement of MRI-based estimates (26 women) (d) inter-reader agreement of XRM CUMULUS estimates (30 women)
Text Fig. 3
Text Fig. 3
Bland-Altman plots of the consistency of the percent density estimates for (a) left/right side consistency of MRI-based estimates (137 women) (b) left/right side consistency of XRM CUMULUS estimates (132 women) (c) inter-reader agreement of MRI-based estimates (26 women) (d) inter-reader agreement of XRM CUMULUS estimates (30 women)
See this image and copyright information in PMC

References

References in Appendices

    1. Brown J, Buckley D, Coulthard A. Magnetic resonance imaging screening in women at genetic risk of breast cancer: imaging and analysis protocol for the UK multi-centre study. Magnetic Resonance Imaging. 2000;18:765–776. - PubMed
    1. Soltanian-Zadeh H, Windham JP. Optimal Processing of Brain MRI. In: Stricland RN, editor. Image-Processing Techniques for Tumor Detection. Marcel Dekker, Inc; 2002.
    1. Khazen M, Warren R, Leach MO. Automated algorithm and a computer tool for identifying tissues contributing to mammographic density using 3D T1-weighted dynamic contrast enhanced MRI of the breast (abstr); Radiological Society of North America scientific assembly and annual meeting program; Oak Brook, IL: Radiological Society of North America; 2005. p. 866.
    1. Khazen M, Warren R, Leach MO. Magnetic Resonance Imaging of the Breast, Analysis and Review (MRIBview): An Image Processing Tool for Structural, Compositional, and Functional Analysis of the Breast, and Computer-assisted Detection (CAD) of Breast Cancer (abstr); Radiological Society of North America scientific assembly and annual meeting program; Oak Brook, IL: Radiological Society of North America; 2006. p. 785.
    1. Khazen M, D'Arcy J, Collins D, Padhany A, Walker-Samuel S, Leach MO. Magnetic Resonance Beast Imaging Analysis and Review (MRIBview) – Specialized Image Processing Workstation for DCE-MRI of the Breast (abstr); Radiological Society of North America scientific assembly and annual meeting program; Oak Brook, IL: Radiological Society of North America; 2004. p. 821.

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