{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T02:56:05Z","timestamp":1778208965938,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T00:00:00Z","timestamp":1468195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Automatically calculated breast density is a promising alternative to subjective BI-RADS density assessment. However, such software needs a cutoff value for density classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine the volumetric density threshold which classifies fatty and dense breasts with highest accuracy compared to average BI-RADS density assessment, and to analyze radiologists\u2019 inter-observer variation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>A total of 537 full field digital mammography examinations were randomly selected from a population based screening program. Five radiologists assessed density using the BI-RADS density scale, where BI-RADS I\u2013II were classified as fatty and III\u2013IV as dense. A commercially available software (Quantra) calculated volumetric breast density. We calculated the cutoff (threshold) values in volumetric density that yielded highest accuracy compared to median and individual radiologists\u2019 classification. Inter-observer variation was analyzed using the kappa statistic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The threshold that best matched the median radiologists\u2019 classification was 10%, which resulted in 87% accuracy. Thresholds that best matched individual radiologist\u2019s classification had a range of 8\u201315%. A total of 191 (35.6 %) cases were scored both dense and fatty by at least one radiologist. Fourteen (2.6 %) cases were unanimously scored by the radiologists, yet differently using automatic assessment. The agreement (kappa) between reader\u2019s median classification and individual radiologists was 0.624 to 0.902, and agreement between median classification and Quantra was 0.731.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The optimal volumetric threshold of 10% using automatic assessment would classify breast parenchyma as fatty or dense with substantial accuracy and consistency compared to radiologists\u2019 BI-RADS categorization, which suffers from high inter-observer variation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0284185115626469","type":"journal-article","created":{"date-parts":[[2016,1,20]],"date-time":"2016-01-20T21:58:52Z","timestamp":1453327132000},"page":"1178-1185","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Classification of fatty and dense breast parenchyma: comparison of automatic volumetric density measurement and radiologists\u2019 classification and their inter-observer variation"],"prefix":"10.1177","volume":"57","author":[{"given":"Bj\u00f8rn Helge","family":"\u00d8ster\u00e5s","sequence":"first","affiliation":[{"name":"The Intervention Centre, Oslo University Hospital, Oslo, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne Catrine T","family":"Martinsen","sequence":"additional","affiliation":[{"name":"The Intervention Centre, Oslo University Hospital, Oslo, Norway"},{"name":"Institute of Physics, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siri Helene B","family":"Brandal","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalida Nasreen","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Eben","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Unni","family":"Haakenaasen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ragnhild S\u00f8rum","family":"Falk","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per","family":"Skaane","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, Norway"},{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,7,11]]},"reference":[{"key":"bibr1-0284185115626469","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-3-200302040-00008"},{"key":"bibr2-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13130724"},{"key":"bibr3-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2013.11.014"},{"key":"bibr4-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-06-0034"},{"key":"bibr5-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2011.173"},{"key":"bibr6-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062790"},{"key":"bibr7-0284185115626469","unstructured":"U.S. Government H.R.3102. Breast Density and Mammography Reporting Act of 2011. Available at: http:\/\/www.gpo.gov\/fdsys\/pkg\/BILLS-112hr3102ih\/pdf\/BILLS-112hr3102ih.pdf (accessed June 2015)."},{"key":"bibr8-0284185115626469","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-1-201107050-00003"},{"key":"bibr9-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2012.11.025"},{"key":"bibr10-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2004.12.004"},{"key":"bibr11-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/90.23.1801"},{"key":"bibr12-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2012.01.005"},{"key":"bibr13-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2007.04.007"},{"key":"bibr14-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4741.2012.01250.x"},{"key":"bibr15-0284185115626469","unstructured":"Rafferty EA, Smith A, Niklason LT. Comparison of three methods of estimating breast density: BI-RADS density scores using full field digital mammography, breast tomosynthesis, and volumetric breast density. Proffered Pap Rad Soc North Am Chicago, USA SsM01. 2009."},{"key":"bibr16-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-014-0390-3"},{"key":"bibr17-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12121373"},{"key":"bibr18-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-013-2820-3"},{"key":"bibr19-0284185115626469","volume-title":"Breast Imaging Reporting and Data System (BI-RADS): Mammography","author":"American College of Radiology","year":"2003","edition":"4"},{"key":"bibr20-0284185115626469","unstructured":"Hologic. Understanding Quantra\u2122 2.0. User manual. MAN-02004 Rev 004, 2012. Available at: http:\/\/stage.hologic.com\/sites\/default\/files\/package%20inserts\/Understanding%20Quantra%202.0%20User%20Manual.%20English.pdf (accessed August 2015)."},{"key":"bibr21-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1002\/9780470906514"},{"key":"bibr22-0284185115626469","volume-title":"Breast Imaging Reporting and Data System (BI-RADS): Mammography","author":"American College of Radiology","year":"2013","edition":"5"},{"key":"bibr23-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-673"},{"key":"bibr24-0284185115626469","unstructured":"Sauber N, Chan A, Highnam R. BI-RADS breast density classification\u2009-\u2009an international standard? Poster Presentation presented at: European Congress of Radiology. 2013 Mar 7\u201311; Vienna, Austria."},{"key":"bibr25-0284185115626469","doi-asserted-by":"publisher","DOI":"10.1177\/0284185113492721"}],"container-title":["Acta Radiologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0284185115626469","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0284185115626469","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0284185115626469","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:19:45Z","timestamp":1777389585000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0284185115626469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,11]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1177\/0284185115626469"],"URL":"https:\/\/doi.org\/10.1177\/0284185115626469","relation":{},"ISSN":["0284-1851","1600-0455"],"issn-type":[{"value":"0284-1851","type":"print"},{"value":"1600-0455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,11]]}}}