Reliability of breast density estimation based on cone beam breast CT / 中国肿瘤临床

ABSTRACT

Objective:To investigate the accuracy of a threshold-based segmentation method based on cone beam breast CT(CBBCT) images in breast density measurement,and its value for breast-type classification and breast cancer screening.Methods:A retrospec-tive analysis of 195 patients who had undergone CBBCT examination at Tianjin Medical University Cancer Institute and Hospital be-tween May 2012 and August 2014 was performed.A total of 64 breasts were analyzed.On the basis of the classification criteria for breast density in BI-RADS,they were classified into four types and the majority report was reported.Breast density was measured by the threshold-based segmentation method based on CBBCT images and corrected manually to obtain the corrected breast density.A month later,the procedure was repeated.Intra-class correlation coefficients(ICCs)were used to compare the intra-observer and inter-observer consistencies of threshold-based segmentation and manually corrected breast density measurement results for non-dense and dense breasts.Results:For threshold-based segmentation measurements the intra-observer and inter-observer ICC values were 0.0.9624(95% CI0.9388~0.9770)and 0.9666(95% CI0.9500~0.9785).For manually corrected measurements,the intra-observer and inter-observer ICC values were 0.9750 (95% CI 0.9592~0.9847) and 0.9775 (95% CI 0.9661~0.9855). The ICC between the threshold-based segmentation method and manual correction was 0.9962 (95% CI 0.9983~0.9977). The ICC values of threshold-based and manually corrected measurement in non-dense and dense breasts were 0.9497(95% CI0.7072-0.9914)and 0.9983(95% CI0.9971-0.9990),respectively.Conclusions:The threshold-based segmentation method based on CBBCT is a reliable and accurate com-puter-aided method of measuring breast density.It is expected to be applied in large-scale screening of breast cancer and to provide more information for predicting the risk of breast cancer.