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Vision 20/20: Mammographic breast density and its clinical applications

机译:视觉20/20:乳房X线摄影术的乳房密度及其临床应用

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Breast density is a strong predictor of the failure of mammography screening to detect breast cancer and is a strong predictor of the risk of developing breast cancer. The many imaging options that are now available for imaging dense breasts show great promise, but there is still the question of determining which women are "dense" and what imaging modality is suitable for individual women. To date, mammographic breast density has been classified according to the Breast Imaging-Reporting and Data System (BI-RADS) categories from visual assessment, but this is known to be very subjective. Despite many research reports, the authors believe there has been a lack of physics-led and evidence-based arguments about what breast density actually is, how it should be measured, and how it should be used. In this paper, the authors attempt to start correcting this situation by reviewing the history of breast density research and the debates generated by the advocacy movement. The authors review the development of breast density estimation from pattern analysis to area-based analysis, and the current automated volumetric breast density (VBD) analysis. This is followed by a discussion on seeking the ground truth of VBD and mapping volumetric methods to BI-RADS density categories. The authors expect great improvement in VBD measurements that will satisfy the needs of radiologists, epidemiologists, surgeons, and physicists. The authors believe that they are now witnessing a paradigm shift toward personalized breast screening, which is going to see many more cancers being detected early, with the use of automated density measurement tools as an important component. (C) 2015 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 Unported License.
机译:乳房密度是乳腺钼靶筛查无法检测到乳腺癌的有力预测指标,也是发生乳腺癌的风险的有力预测指标。现在可用于对致密的乳房进行成像的许多成像选项显示出了巨大的希望,但是仍然存在确定哪些女性“密集”以及哪种成像方式适合个别女性的问题。迄今为止,乳房X光检查的乳房密度已根据视觉评估根据乳房成像报告和数据系统(BI-RADS)类别进行了分类,但众所周知这是非常主观的。尽管有许多研究报告,但作者认为,对于实际的乳腺密度,如何测量以及如何使用,缺乏物理学上的和循证的论据。在本文中,作者试图通过回顾乳房密度研究的历史以及倡导运动引发的辩论来开始纠正这种情况。作者回顾了乳房密度估计从模式分析到基于区域的分析以及当前的自动体积乳房密度(VBD)分析的发展。接下来是关于寻找VBD的基本事实并将体积方法映射到BI-RADS密度类别的讨论。作者期望VBD测量有很大的进步,可以满足放射科医生,流行病学家,外科医生和物理学家的需求。作者认为,他们现在目睹了朝着个性化乳房筛查的范例转变,通过使用自动密度测量工具作为重要组成部分,它将发现更多的早期癌症被发现。 (C)2015年作者。除另有说明外,所有文章内容均根据知识共享署名3.0未移植许可证进行许可。

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