Abstract

In Japan, radiologists perform qualitative visual classification to define four categories of mammary gland density. However, an objective estimation of mammary gland density is necessary. To address this, we developed an automatic classification software using image similarity. We prepared 741 cases of mediolateral oblique images (MLO) for evaluation, and they were diagnosed as normal among the mammography images taken at our hospital. Image matching was performed using the evaluation images and an image database for breast density determination. In this study, the image similarity used zero normalized cross-correlation (ZNCC) as an index. In addition, if the breast thickness is less than 30 mm and each breast density category ZNNC has the same value, the category is evaluated on the fat side. We compared the results of qualitative visual classification and automatic classification methods to assess consistency. The agreement with the subjective breast composition classification was 78.5%, and the weighted kappa coefficient was 0.98. One mismatched case was evaluated on the higher density side with the same ZNCC value between categories and a breast thickness greater than 30 mm. Image similarity provides an excellent estimation of quantification of breast density. This system could contribute to improving the efficiency of the mammography screening system.

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