Affiliations 

  • 1 Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon, Cedex 09, France. [email protected]
  • 2 Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon, Cedex 09, France
  • 3 Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia, Perth, Australia
  • 4 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
  • 5 Moffitt Cancer Center, Tampa, FL, USA
  • 6 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
  • 7 Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
  • 8 Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
  • 9 Centre for Medical Image Computing, University College London, London, UK
  • 10 Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  • 11 Marmara University School of Medicine Department of Radiology, Istanbul, Turkey
  • 12 Slone Epidemiology Center, Boston University, Boston, MA, USA
  • 13 Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, People's Republic of China
  • 14 Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
  • 15 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  • 16 Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid, Spain
  • 17 Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
  • 18 Cancer Research Malaysia, Subang Jaya, Malaysia
  • 19 Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
  • 20 Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City, Mexico
  • 21 Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
  • 22 National Cancer Control Center, Haifa, Israel
  • 23 Cancer Registry of Norway, Oslo, Norway
  • 24 Norwegian Center for Minority and Migrant Health Research (NAKMI), Oslo, Norway
  • 25 Department of Population Sciences, Beckman Research Institute, City of Hope, CA, USA
  • 26 Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
  • 27 Isfahan University of Medical Sciences, Isfahan, Iran
  • 28 Department of Surgery, Asan Medical Center, Seoul, Republic of Korea
  • 29 Cairo University, Cairo, Egypt
  • 30 Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo, Egypt
  • 31 Department of Surgery, Yong Loo Lin School of Medicine, Singapore, Singapore
  • 32 Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
  • 33 NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore
  • 34 Gifu University, Gifu, Japan
  • 35 Aga Khan University Hospital, Nairobi, Kenya
  • 36 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  • 37 Nofer Institute of Occupational Medicine, Łódz, Poland
  • 38 Department of Imaging, Royal Marsden NHS Foundation Trust, London, UK
  • 39 Division of Cancer Research, Ninewells Hospital & Medical School, Dundee, UK
  • 40 Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
  • 41 Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Canada
  • 42 Princess Margaret Cancer Centre, Toronto, Canada
  • 43 University of Hawaii Cancer Center, Honolulu, HI, USA
  • 44 Medical Biophysics, University of Toronto, Toronto, Canada
  • 45 Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
Breast Cancer Res, 2016 12 19;18(1):130.
PMID: 27993168

Abstract

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 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.