Estimation of effective x-ray tissue attenuation differences for volumetric breast density measurement

Breast density has been identified to be a risk factor of developing breast cancer and an indicator of lesion diagnostic obstruction due to masking effect. Volumetric density measurement evaluates fibro-glandular volume, breast volume, and breast volume density measures that have potential advantages over area density measurement in risk assessment. One class of volume density computing methods is based on the finding of the relative fibro-glandular tissue attenuation with regards to the reference fat tissue, and the estimation of the effective x-ray tissue attenuation differences between the fibro-glandular and fat tissue is key to volumetric breast density computing. We have modeled the effective attenuation difference as a function of actual x-ray skin entrance spectrum, breast thickness, fibro-glandular tissue thickness distribution, and detector efficiency. Compared to other approaches, our method has threefold advantages: (1) avoids the system calibration-based creation of effective attenuation differences which may introduce tedious calibrations for each imaging system and may not reflect the spectrum change and scatter induced overestimation or underestimation of breast density; (2) obtains the system specific separate and differential attenuation values of fibroglandular and fat for each mammographic image; and (3) further reduces the impact of breast thickness accuracy to volumetric breast density. A quantitative breast volume phantom with a set of equivalent fibro-glandular thicknesses has been used to evaluate the volume breast density measurement with the proposed method. The experimental results have shown that the method has significantly improved the accuracy of estimating breast density.