Breast density is confirmed as a strong, independent risk factor of breast cancer which is why there is a clinical need for a robust, reader-independent, non-ionizing, quantitative assessment of breast density. This retrospective study proposes the proton density fat fraction (PDFF) derived from chemical shift encoding-based water-fat separation as a novel quantitative MRI biomarker of breast density. As a clinically highly practicable biomarker that is automatedly obtainable and insensitive to acquisition parameters and the partial volume effect, the PDFF significantly negatively correlated with the most commonly used conventional radiographic mammogram breast density estimations.
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