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Here we investigate the precision and accuracy of pNMR measurements of MD ex vivo as compared with the gold standards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010five breast\u2010tissue explants from 9 prophylactic mastectomy patients were measured. The relative tissue water content was taken as the MD\u2010equivalent quantity. In each sample, the water content was measured using some combination of three pNMR techniques (apparent T<jats:sub>2<\/jats:sub>, diffusion, and T<jats:sub>1<\/jats:sub>measurements) and two gold\u2010standard techniques (computed microtomography [\u03bcCT] and hematoxylin and eosin [H&amp;E] histology). Pairwise correlation plots and Bland\u2013Altman analysis were used to quantify the degree of agreement between pNMR techniques and the gold standards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Relative water content measured from both apparent T<jats:sub>2<\/jats:sub>relaxation spectra, and diffusion decays exhibited strong correlation with the H&amp;E and \u03bcCT results. Bland\u2013Altman analysis yielded average bias values of \u22120.4, \u22122.6, 2.6, and 2.8 water percentage points (pp) and 95% confidence intervals of 13.1, 7.5, 11.2, and 11.8\u2009pp for the H&amp;E \u2013 T<jats:sub>2<\/jats:sub>, \u03bcCT \u2013 T<jats:sub>2<\/jats:sub>, H&amp;E \u2013 diffusion, and \u03bcCT \u2013 diffusion comparison pairs, respectively. T<jats:sub>1<\/jats:sub>\u2010based measurements were found to be less reliable, with the Bland\u2013Altman confidence intervals of 27.7 and 33.0\u2009pp when compared with H&amp;E and \u03bcCT, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Apparent T<jats:sub>2<\/jats:sub>\u2010based and diffusion\u2010based pNMR measurements enable quantification of MD in breast\u2010tissue explants with the precision of approximately 10\u2009pp and accuracy of approximately 3\u2009pp or better, making pNMR a promising measurement modality for radiation\u2010free quantification of MD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mrm.30040","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T11:46:49Z","timestamp":1708516009000},"page":"374-388","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative measurement of mammographic density in breast\u2010tissue explants using portable NMR: Precision and accuracy"],"prefix":"10.1002","volume":"92","author":[{"given":"Satcha","family":"Foongkajornkiat","sequence":"first","affiliation":[{"name":"School of Chemistry and Physics Queensland University of Technology Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamil","family":"Sokolowski","sequence":"additional","affiliation":[{"name":"Preclincal Imaging Facility Translational Research Institute Woolloongabba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Stephenson","sequence":"additional","affiliation":[{"name":"Department of Breast and Endocrine Surgery Princess Alexandra Hospital Woolloongabba Queensland Australia"},{"name":"Translational Research Institute Woolloongabba Queensland 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