Assessment of change in breast density: reader performance using synthetic mammographic images

Jamie Sergeant, Susan Astley, Chitra Swayamprakasam, Michael Berks, Julie Morris, Mary Wilson, Nicky Barr, Caroline Boggis

    Research output: Chapter in Book/Report/Conference proceedingConference contribution


    A recent study has shown that breast cancer risk can be reduced by taking Tamoxifen, but only if this results in at least a 10% point reduction in mammographic density. When mammographic density is quantified visually, it is impossible to assess reader accuracy using clinical images as the ground truth is unknown. Our aim was to compare three models of assessing density change and to determine reader accuracy in identifying reductions of 10% points or more. We created 100 synthetic, mammogram-like images comprising 50 pairs designed to simulate natural reduction in density within each pair. Model 1: individual images were presented to readers and density assessed. Model 2: pairs of images were displayed together, with readers assessing density for each image. Model 3: pairs of images were displayed together, and readers asked whether there was at least a 10% point reduction in density. Ten expert readers participated. Readers’ estimates of percentage density were significantly closer to the truth (6.8%-26.4%) when images were assessed individually rather than in pairs (9.6%-29.8%). Measurement of change was significantly more accurate in Model 2 than Model 1 (p
    Original languageEnglish
    Title of host publicationSPIE Medical Imaging 2012 Volume 8318 : Image Perception, Observer Performance and Technology Assessment
    EditorsCraig Abbey, Claudia Mello-Thoms
    Place of PublicationUSA
    Publication statusPublished - Feb 2012
    EventSPIE Medical Imaging - San Diego, California
    Duration: 1 Jan 1824 → …


    ConferenceSPIE Medical Imaging
    CitySan Diego, California
    Period1/01/24 → …


    • mammogram
    • breast density
    • visual
    • visual analogue scale
    • synthetic
    • observer


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