Radiological researchers in India have shown that a fully automated volumetric method can reliably provide accurate quantification of breast density.

Tulika Singh, MD, of the Post Graduate Institute of Medical Education and Research in the northern territory of Chandigarh, and colleagues found almost perfect agreement between this method and BI-RADS density categories as assigned by two radiologists.

Their study posted online Oct. 27 in Academic Radiology.

In the study, two blinded radiologists evaluated 476 full-field digital mammography exams with standard mediolateral oblique and craniocaudal views.

The two radiologists first assigned BI-RADS density categories, then used fully automated software marketed by New Zealand-based Volpara Solutions to calculate mean fibroglandular tissue volume, mean breast volume and mean volumetric breast density.

Assigning a volumetric density grade of 1 to 4, and basing the grade on percentage volumetric breast density, they achieved a weighted overall coefficient of 0.895—quite close to perfect—when correlating with their BI-RADS density estimates.

On visual assessment, less than a quarter of the study population was categorized as BI-RADS 3 or BI-RADS 4. Of the 476 exams, 444 (93.3 percent) showed agreement between BI-RADS grading of both the radiologists. In the 32 patients with disagreement, differences were within one category only.

Also, study authors recorded a significant difference between volumetric breast density of all BI-RADS categories, and noted that volumetric breast density increased with increased BI-RADS category.

The authors conclude that a fully automated volumetric method “could be used for quantification of breast density. However, further studies are required to evaluate the causes of disagreement between visual assessment and automated density measurement.”