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Ultraschall Med 2012; 33(4): 357-365
DOI: 10.1055/s-0031-1299128
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Sonografische Mikrokalkdetektion – Potenzial einer neuen Methode

Sonographic Detection of Microcalcifications – Potential of New Method
T. Fischer
1   Institut of Radiology and Ultrasound Research Laboratory, Charité – Universitätsmedizin Berlin
,
M. Grigoryev
1   Institut of Radiology and Ultrasound Research Laboratory, Charité – Universitätsmedizin Berlin
,
S. Bossenz
2   Department of Obstetrics and Gynaecology and Ultrasound Research Laboratory, Charité – Universitätsmedizin Berlin
,
F. Diekmann
1   Institut of Radiology and Ultrasound Research Laboratory, Charité – Universitätsmedizin Berlin
,
U. Bick
1   Institut of Radiology and Ultrasound Research Laboratory, Charité – Universitätsmedizin Berlin
,
T. Slowinski
3   Department of Nephrology, Charité – Universitätsmedizin Berlin
,
A. Thomas
2   Department of Obstetrics and Gynaecology and Ultrasound Research Laboratory, Charité – Universitätsmedizin Berlin
› Author Affiliations
Further Information

Publication History

08 July 2011

13 December 2011

Publication Date:
09 February 2012 (online)

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Zusammenfassung

Ziel: Ermöglicht die erleichterte Mikrokalkdetektionsmethode (EMD) die sonografische Mikrokalkdarstellung an stereotaktisch gewonnenen Mammastanzzylindern im Vergleich zur Mammografie?

Material und Methoden: In einer prospektiv randomisierten Studie wurden 105 stereotaktisch gewonnen Stanzzylinder mammografisch und sonografisch untersucht. Die EMD-Methode, integriert in ein High-end-Ultraschallsystem, bestand aus 3 Einstellungsstufen (0 – 2 blau, 3 – 5 violett und 6 – 8 schwarz-weiß, 14 MHz). Die Anzahl der Mikroverkalkungen pro Stanze wurde für beide Verfahren bestimmt. Die EMD-Bildqualität konnte auf einer Skala von 1 – 9 beurteilt werden. ANOVA und Post-Hoc nach Sidak, Regressionsanalyse nach Pearson (r) und Spearmansche Rangrelationskorrelation (rho) wurden ermittelt. Der Intraklassen-Korrelationskoeffizient (ICC) wurde berechnet und eine ROC-Analyse durchgeführt.

Ergebnisse: Die blaue Farbmappe 1 wurde mit 1,5 ± 0,7 (MW) am besten bewertet (p< 0,05 im Vergleich zu schwarz-weiß und violett). Bei einer guter Korrelation der Verfahren (r = 0,708 und rho = 0,694) lag die Anzahl der erkannten Mikroverkalkungen pro Stanze bei 3,5 ± 3,1 sonografisch und 4,3 ± 4,8 mammografisch (p> 0,05). Der ICC zeigte mit 0,773 eine nur geringe Abweichung der Verfahren. Basierend auf dem histologischen Nachweis der Verkalkungen war die Mammografie der Sonografie in der ROC-Analyse überlegen (AUC = 0,837 vs. AUC = 0,728).

Schlussfolgerung: Die sonografische Mikrokalkdetektion mittels EMD-Methode korreliert gut mit der digitalen Mammografie an stereotaktisch gewonnenen Stanzen. Die Verfahren weichen gering zugunsten der Mammografie voneinander ab.

Abstract

Purpose: Does the easier microcalcification detection (EMD) method enable sonographic visualization of microcalcifications in breast core biopsy specimens compared with mammography?

Materials and Methods: In a prospective randomized study, 105 core biopsy specimens obtained with stereotactic guidance were examined by mammography and ultrasound. EMD is integrated in a high-end ultrasound system and uses three level settings (0 – 2 blue, 3 – 5 violet, and 6 – 8 black-and-white; 14 MHz). Detection of microcalcifications per core specimen was determined for ultrasound and mammography. EMD image quality was rated on a scale of 1 – 9. ANOVA and Sidak post-hoc testing, Pearson regression analysis (r), and Spearman rank correlation (rho) were performed. The intraclass correlation coefficient (ICC) was calculated, and an ROC analysis was conducted.

Results: The blue color map 1 was assigned the highest mean score of 1.5 ± 0.7 (p< 0.05 compared with black-and-white and violet). There was good correlation between the two modalities (r= 0.708 and rho= 0.694) with detection of 3.5 ± 3.1 microcalcifications per specimen by ultrasound versus 4.3 ± 4.8 by mammography (p> 0.05). The ICC of 0.773 indicates little disagreement between the two modalities. ROC analysis showed mammography to be superior to ultrasound compared with histological detection of microcalcifications (AUC= 0.837 vs. AUC= 0.728).

Conclusion: Sonographic detection of microcalcifications in stereotactic biopsy specimens using the EMD method correlates well with digital mammography. Mammography is slightly superior.

Key words

breast ultrasound - sonographic detection of microcalcifications - microcalcifications - stereotactic biopsy
 

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