A Pilot Study of Compositional Analysis of the Breast and Estimation of Breast Mammographic Density Using Three-Dimensional T1-Weighted Magnetic Resonance Imaging

Purpose: A method and computer tool to estimate percentage magnetic resonance (MR) imaging (MRI) breast density using three-dimensional T1-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 T1-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.(Cancer Epidemiol Biomarkers Prev 2008;17(9):2268–74)

[1]  V. McCormack,et al.  Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis , 2006, Cancer Epidemiology Biomarkers & Prevention.

[2]  N. Boyd,et al.  Mammographic density and the risk and detection of breast cancer. , 2007, The New England journal of medicine.

[3]  R. Warren,et al.  Magnetic resonance imaging screening in women at genetic risk of breast cancer: imaging and analysis protocol for the UK multicentre study , 2000 .

[4]  H Rusinek,et al.  Fatty and fibroglandular tissue volumes in the breasts of women 20-83 years old: comparison of X-ray mammography and computer-assisted MR imaging. , 1997, AJR. American journal of roentgenology.

[5]  A. Miller,et al.  Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. , 1995, Journal of the National Cancer Institute.

[6]  Stephen W Duffy,et al.  A breast cancer prediction model incorporating familial and personal risk factors , 2004, Hereditary Cancer in Clinical Practice.

[7]  Stephen W Duffy,et al.  Tamoxifen and breast density in women at increased risk of breast cancer. , 2004, Journal of the National Cancer Institute.

[8]  N. Boyd,et al.  Analysis of mammographic density and breast cancer risk from digitized mammograms. , 1998, Radiographics : a review publication of the Radiological Society of North America, Inc.

[9]  C S Poon,et al.  Quantitative magnetic resonance imaging parameters and their relationship to mammographic pattern. , 1992, Journal of the National Cancer Institute.

[10]  Russell Davies,et al.  Mammographic density and breast cancer risk in BRCA1 and BRCA2 mutation carriers. , 2006, Cancer research.

[11]  C. Klifa,et al.  Quantification of breast tissue index from MR data using fuzzy clustering , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[12]  D. Evans,et al.  Germ-line mutations of TP53 in Li-Fraumeni families: an extended study of 39 families. , 1997, Cancer research.

[13]  M. Yaffe,et al.  American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography , 2007, CA: a cancer journal for clinicians.

[14]  A R Padhani,et al.  Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS) , 2005, The Lancet.

[15]  R. Given-Wilson,et al.  Breast cancer risk and possible screening strategies for young women following supradiaphragmatic irradiation for Hodgkin's disease. , 2004, Clinical radiology.

[16]  Berkman Sahiner,et al.  Correlation between mammographic density and volumetric fibroglandular tissue estimated on breast MR images. , 2004, Medical physics.

[17]  N. Boyd,et al.  The quantitative analysis of mammographic densities. , 1994, Physics in medicine and biology.

[18]  S. J. Graham,et al.  Quantitative correlation of breast tissue parameters using magnetic resonance and X-ray mammography. , 1996, British Journal of Cancer.