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Calibrated breast density methods for full field digital mammography: A
system for serial quality control and inter-system generalization
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The authors are developing a system for calibrated breast density measurements
using full field digital mammography (FFDM). Breast tissue equivalent (BTE)
phantom images are used to establish baseline (BL) calibration curves at
time zero. For a given FFDM unit, the full BL dataset is comprised of
approximately 160 phantom images, acquired prior to calibrating
prospective patient mammograms. BL curves are monitored serially to ensure they
produce accurate calibration and require updating when calibration accuracy
degrades beyond an acceptable tolerance, rather than acquiring full BL datasets
repeatedly. BL updating is a special case of generalizing calibration datasets
across FFDM units, referred to as cross-calibration. Serial monitoring, BL
updating, and cross-calibration techniques were developed and evaluated.
BL curves were established for three Hologic Selenia FFDM units at time zero. In
addition, one set of serial phantom images, comprised of equal proportions of
adipose and fibroglandular BTE materials (50/50 compositions) of a fixed height,
was acquired biweekly and monitored with the cumulative sum (Cusum) technique.
These 50/50 composition images were used to update the BL curves
when the calibration accuracy degraded beyond a preset tolerance of ±4
standardized units. A second set of serial images,
comprised of a wide-range of BTE compositions, was acquired biweekly to evaluate
serial monitoring, BL updating, and cross-calibration techniques.
Calibration accuracy can degrade serially and is a function of
acquisition technique and phantom height. The authors demonstrated that all
heights could be monitored simultaneously while acquiring images of a
50/50 phantom with a fixed height for each acquisition technique biweekly,
translating into approximately 16 image acquisitions biweekly per FFDM unit. The
same serial images are sufficient for serial monitoring, BL updating, and
cross-calibration. Serial calibration accuracy was maintained within ±4 standardized
unit variation from the ideal when applying BL updating. BL updating is a special
case of cross-calibration; the BL dataset of unit 1 can be converted to the BL
dataset for another similar unit (i.e., unit 2) at any given time point using the
16 serial monitoring 50/50 phantom images of unit 2 (or vice versa) acquired
near this time point while maintaining the ±4 standardized unit tolerance.
A methodology for monitoring and maintaining serial calibration accuracy
for breast density
measurements was evaluated. Calibration datasets
for a given unit can be translated forward in time with minimal phantom
imaging effort. Similarly, cross-calibration is a method for
generalizing calibration datasets across similar units without additional
phantom imaging. This methodology will require further evaluation with
mammograms for complete validation.
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