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Recent changes in the BI\u2010RADS\u00ae density assessment address the effect of masking by densities, but the BI\u2010RADS\u00ae assessment remains qualitative and achieves only moderate agreement between radiologists. An automated, quantitative algorithm that estimates the likelihood of masking of simulated masses in a mammogram by dense tissue has been developed. The algorithm considers both the effects of loss of contrast due to density and the distracting texture or appearance of dense tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>A local detectability (<jats:italic>d<jats:sub>L<\/jats:sub><\/jats:italic>) map is created by tessellating the mammograms into overlapping regions of interest (ROIs), for which the detectability by a non\u2010prewhitening observer is computed using local estimates of the noise power spectrum and volumetric breast density (VBD). The <jats:italic>d<jats:sub>L<\/jats:sub><\/jats:italic> calculation was validated in a 4\u2010alternative forced\u2010choice observer study on the ROIs of 150 craniocaudal digital mammograms. The <jats:italic>d<jats:sub>L<\/jats:sub><\/jats:italic> metric was compared against the inverse threshold contrast, (\u0394<jats:italic>\u03bcT<\/jats:italic>)<jats:sup>\u22121<\/jats:sup> from the observer study, the anatomic noise parameter <jats:italic>\u03b2<\/jats:italic>, the radiologist's BI\u2010RADS\u00ae density category, and a validated measure of VBD (Cumulus).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The mean <jats:italic>d<jats:sub>L<\/jats:sub><\/jats:italic> had a high correlation of <jats:italic>r<\/jats:italic> = 0.915 and <jats:italic>r<\/jats:italic> = 0.699 with (\u0394<jats:italic>\u03bcT<\/jats:italic>)<jats:sup>\u22121<\/jats:sup> in the computerized and human observer study, respectively. In comparison, the local VBD estimate had a low correlation of 0.538 with (\u0394<jats:italic>\u03bcT<\/jats:italic>)<jats:sup>\u22121<\/jats:sup>. The mean <jats:italic>d<jats:sub>L<\/jats:sub><\/jats:italic> had a correlation of 0.663, 0.835, and 0.696 with BI\u2010RADS density, <jats:italic>\u03b2<\/jats:italic>, and Cumulus VBD, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The proposed <jats:italic>d<jats:sub>L<\/jats:sub><\/jats:italic> metric may be useful in characterizing the potential for lesion masking by dense tissue. Because it uses information about the anatomic noise or tissue appearance, it is more closely linked to lesion detectability than VBD metrics.<\/jats:p><\/jats:sec>","DOI":"10.1118\/1.4941307","type":"journal-article","created":{"date-parts":[[2016,2,11]],"date-time":"2016-02-11T09:18:29Z","timestamp":1455182309000},"page":"1249-1258","update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":21,"title":["Quantifying masking in clinical mammograms via local detectability of simulated lesions"],"prefix":"10.1002","volume":"43","author":[{"given":"James G.","family":"Mainprize","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Alonzo\u2010Proulx","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta A.","family":"Jong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin J.","family":"Yaffe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010155\u20108\u2010201110180\u201000005"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052911"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2461070200"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/92.13.1081"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062790"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2004.12.004"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/21256379"},{"volume-title":"ACR BI\u2010RADS\u00ae Atlas, Breast Imaging Reporting and Data System","year":"2013","author":"Sickles E. 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