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Currently, two open-source publicly available packages (LIBRA and OpenBreast) provide algorithms for pectoral muscle removal within Matlab environment. <\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To compare performance of the two packages on a single database of FFDM images. <\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Only mediolateral oblique (MLO) FFDM was considered because of large presence of pectoral muscle on this type of projection. For obtaining ground truth, pectoral muscle has been manually segmented by two radiologists in consensus. Both LIBRA\u2019s and OpenBreast\u2019s removal performance with respect to ground truth were compared using Dice similarity coefficient and Cohen-kappa reliability coefficient; Wilcoxon signed-rank test has been used for assessing differences in performances; Kruskal\u2013Wallis test has been used to verify possible dependence of the performance from the breast density or image laterality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>FFDMs from 168 consecutive women at our institution have been included in the study. Both LIBRA\u2019s Dice-index and Cohen-kappa were significantly higher than OpenBreast (Wilcoxon signed-rank test <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). No dependence on breast density or laterality has been found (Kruskal\u2013Wallis test <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). Conclusion: Libra has a better performance than OpenBreast in pectoral muscle delineation so that, although our study has not a direct clinical application, these results are useful in the choice of packages for the development of complex systems for computer-aided breast evaluation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11547-022-01521-5","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T13:03:07Z","timestamp":1657544587000},"page":"848-856","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Comparison between two packages for pectoral muscle removal on mammographic images"],"prefix":"10.1007","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3556-7771","authenticated-orcid":false,"given":"Mario","family":"Sansone","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Marrone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giusi","family":"Di Salvio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Paola","family":"Belfiore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Gatta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Fusco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Vanore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Zuiani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Grassi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Vietri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenza","family":"Granata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Grassi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,7,11]]},"reference":[{"issue":"4","key":"1521_CR1","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.radi.2017.03.004","volume":"23","author":"K Taylor","year":"2017","unstructured":"Taylor K, Parashar D, Bouverat G, Poulos A, Gullien R, Stewart E, Aarre R, Crystal P, Wallis M (2017) Mammographic image quality in relation to positioning of the breast: A multicentre international evaluation of the assessment systems currently used, to provide an evidence base for establishing a standardised method of assessment. 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N Engl J Med 356(3):227\u2013236. https:\/\/doi.org\/10.1056\/NEJMoa062790","journal-title":"N Engl J Med"}],"container-title":["La radiologia medica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11547-022-01521-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11547-022-01521-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11547-022-01521-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T12:28:26Z","timestamp":1659529706000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11547-022-01521-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,11]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["1521"],"URL":"https:\/\/doi.org\/10.1007\/s11547-022-01521-5","relation":{},"ISSN":["1826-6983"],"issn-type":[{"type":"electronic","value":"1826-6983"}],"subject":[],"published":{"date-parts":[[2022,7,11]]},"assertion":[{"value":"11 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"On behalf of all authors, the corresponding author states that there is no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval was obtained from the ethics committee of University \u201cLuigi Vanvitelli,\u201d Naples, Italy. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}},{"value":"As this work is included within a larger project, informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}