Journal of Medical Imaging and Radiation Oncology

Medical Imaging—Original Article

Inter-observer variability in mammographic density assessment using Royal Australian and New Zealand College of Radiologists (RANZCR) synoptic scales

Corresponding Author

Christine N Damases

Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia

Faculty of Health Sciences, Allied Health Department, University of Namibia, Windhoek, Namibia

Correspondence

Ms. Christine N Damases, Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Centre, The University of Sydney, 75 East St, Lidcombe, Sydney, NSW 2141, Australia.

Email: [email protected]

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Claudia Mello-Thoms,

Claudia Mello-Thoms

Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia

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Mark F McEntee,

Mark F McEntee

Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia

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Christine N Damases,

Corresponding Author

Christine N Damases

Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia

Faculty of Health Sciences, Allied Health Department, University of Namibia, Windhoek, Namibia

Correspondence

Ms. Christine N Damases, Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Centre, The University of Sydney, 75 East St, Lidcombe, Sydney, NSW 2141, Australia.

Email: [email protected]

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Claudia Mello-Thoms,

Claudia Mello-Thoms

Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia

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Mark F McEntee,

Mark F McEntee

Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia

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First published: 05 April 2016

https://doi.org/10.1111/1754-9485.12451

Citations: 4

CN Damases MTech Radiography; C Mello-Thoms PhD; MF McEntee BSc (Hons) Radiography, PhD.

Conflict of interest: None.

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Abstract

Introduction

The aim of this study was to evaluate observer variability in mammographic density assessment as measured using the Royal Australian and New Zealand College of Radiologists (RANZCR) synoptic scales. Visual assessment of mammographic density by radiologists is commonly used in clinical practice; however, these assessments have been shown to be more subjective than quantitative methods.

Methods

The study included 40 cases of left cranial-caudal (CC) and mediolateral oblique (MLO) radiographs from 20 women. RANZCR-registered radiologists (n = 26) estimated mammographic breast density of the same images according to RANZCR synoptic scales 1–4. All images had their volumetric density classified using Volpara Density Grade (VDG) and Average Volumetric Breast Density percentage (AvBD%).

Results

The results showed that the radiologists sampled had specialized for 17.18 years (sd 12.03) and read 2072 (sd 2441) mammograms per year on average. Inter-observer agreement using RANZCR synoptic scales had an average Kappa of 0.360; (95% CI = 0.308–0.412) and a range of 0.078–0.499. Radiologists estimated percentage density was lower by 0.37 than VDG, with their mean being 2.18 and the mean VDG was 2.55 (Z = −3.873; P < 0.001). VDG and RANZCR showed a positive strong correlation (ρ = 0.898; P < 0.001). AvBD% and RANZCR also showed a positive strong correlation (ρ = 0.904; P < 0.001).

Conclusion

The inter-observer agreement with RANZCR synoptic scales was fair. Wide inter-observer variability was observed. Continued research on appropriate assessment methods for mammographic density assessment is required to avoid unnecessary variations.

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Volume60, Issue3

June 2016

Pages 329-336

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Inter-observer variability in mammographic density assessment using Royal Australian and New Zealand College of Radiologists (RANZCR) synoptic scales

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Inter-observer variability in mammographic density assessment using Royal Australian and New Zealand College of Radiologists (RANZCR) synoptic scales

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