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Media type:
E-Article
Title:
Inter‐observer variability in mammographic density assessment using Royal Australian and New Zealand College of Radiologists (RANZCR) synoptic scales
Contributor:
Damases, Christine N;
Mello‐Thoms, Claudia;
McEntee, Mark F
imprint:
Wiley, 2016
Published in:Journal of Medical Imaging and Radiation Oncology
Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>The aim of this study was to evaluate observer variability in mammographic density assessment as measured using the Royal Australian and New Zealand College of Radiologists (<jats:styled-content style="fixed-case">RANZCR</jats:styled-content>) synoptic scales. Visual assessment of mammographic density by radiologists is commonly used in clinical practice; however, these assessments have been shown to be more subjective than quantitative methods.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The study included 40 cases of left cranial‐caudal (<jats:styled-content style="fixed-case">CC</jats:styled-content>) and mediolateral oblique (<jats:styled-content style="fixed-case">MLO</jats:styled-content>) radiographs from 20 women. <jats:styled-content style="fixed-case">RANZCR</jats:styled-content>‐registered radiologists (<jats:italic>n</jats:italic> = 26) estimated mammographic breast density of the same images according to <jats:styled-content style="fixed-case">RANZCR</jats:styled-content> synoptic scales 1–4. All images had their volumetric density classified using Volpara Density Grade (<jats:styled-content style="fixed-case">VDG</jats:styled-content>) and Average Volumetric Breast Density percentage (Av<jats:styled-content style="fixed-case">BD</jats:styled-content>%).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The results showed that the radiologists sampled had specialized for 17.18 years (<jats:italic>sd</jats:italic> 12.03) and read 2072 (<jats:italic>sd</jats:italic> 2441) mammograms per year on average. Inter‐observer agreement using <jats:styled-content style="fixed-case">RANZCR</jats:styled-content> synoptic scales had an average Kappa of 0.360; (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> = 0.308–0.412) and a range of 0.078–0.499. Radiologists estimated percentage density was lower by 0.37 than <jats:styled-content style="fixed-case">VDG</jats:styled-content>, with their mean being 2.18 and the mean <jats:styled-content style="fixed-case">VDG</jats:styled-content> was 2.55 (<jats:italic>Z</jats:italic> = −3.873; <jats:italic>P</jats:italic> < 0.001). <jats:styled-content style="fixed-case">VDG</jats:styled-content> and <jats:styled-content style="fixed-case">RANZCR</jats:styled-content> showed a positive strong correlation (ρ = 0.898; <jats:italic>P</jats:italic> < 0.001). Av<jats:styled-content style="fixed-case">BD</jats:styled-content>% and <jats:styled-content style="fixed-case">RANZCR</jats:styled-content> also showed a positive strong correlation (ρ = 0.904; <jats:italic>P</jats:italic> < 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The inter‐observer agreement with <jats:styled-content style="fixed-case">RANZCR</jats:styled-content> synoptic scales was fair. Wide inter‐observer variability was observed. Continued research on appropriate assessment methods for mammographic density assessment is required to avoid unnecessary variations.</jats:p></jats:sec>