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Wiley, Medical Physics, 12(39), p. 7317-7328, 2012

DOI: 10.1118/1.4765050

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Dedicated breast CT: Fibroglandular volume measurements in a diagnostic population: Fibroglandular volume in breast CT

Journal article published in 2012 by Srinivasan Vedantham ORCID, Linxi Shi, Andrew Karellas, Avice M. O'Connell
This paper is available in a repository.
This paper is available in a repository.

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Data provided by SHERPA/RoMEO

Abstract

PURPOSE: To determine the mean and range of volumetric glandular fraction (VGF) of the breast in a diagnostic population using a high-resolution flat-panel cone-beam dedicated breast CT system. This information is important for Monte Carlo-based estimation of normalized glandular dose coefficients and for investigating the dependence of VGF on breast dimensions, race, and pathology. METHODS: Image data from a clinical trial investigating the role of dedicated breast CT that enrolled 150 women were retrospectively analyzed to determine the VGF. The study was conducted in adherence to a protocol approved by the institutional human subjects review boards and written informed consent was obtained from all study participants. All participants in the study were assigned BI-RADS((R)) 4 or 5 as per the American College of Radiology assessment categories after standard diagnostic work-up and underwent dedicated breast CT exam prior to biopsy. A Gaussian-kernel based fuzzy c-means algorithm was used to partition the breast CT images into adipose and fibroglandular tissue after segmenting the skin. Upon determination of the accuracy of the algorithm with a phantom, it was applied to 137 breast CT volumes from 136 women. VGF was determined for each breast and the mean and range were determined. Pathology results with classification as benign, malignant, and hyperplasia were available for 132 women, and were used to investigate if the distributions of VGF varied with pathology. RESULTS: The algorithm was accurate to within +/-1.9% in determining the volume of an irregular shaped phantom. The study mean (+/- inter-breast SD) for the VGF was 0.172 +/- 0.142 (range: 0.012-0.719). VGF was found to be negatively correlated with age, breast dimensions (chest-wall to nipple length, pectoralis to nipple length, and effective diameter at chest-wall), and total breast volume, and positively correlated with fibroglandular volume. Based on pathology, pairwise statistical analysis (Mann-Whitney test) indicated that at the 0.05 significance level, there was no significant difference in distributions of VGF without adjustment for age between malignant and nonmalignant breasts (p = 0.41). Pairwise comparisons of the distributions of VGF in increasing order of mammographic breast density indicated all comparisons were statistically significant (p