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DOI: 10.1055/s-0033-1350572
Impact of Magnification Views on the Characterization of Microcalcifications in Digital Mammography
Einfluss der Vergrößerungsaufnahme auf die Charakterisierung von Mikroverkalkungen in der digitalen MammografiePublikationsverlauf
25. Januar 2013
07. August 2013
Publikationsdatum:
02. September 2013 (online)
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Abstract
Purpose: To evaluate the additional benefit of true geometric (air-gap) magnification views for the characterization of microcalcifications in digital mammography.
Materials and Methods: After ethical approval, we retrospectively reviewed patient records to identify 100 patients with suspicious microcalcifications (35 malignant, 65 benign) who had a standard digital mammography and an additional digital magnification view in the same projection within three months. All images were obtained using an amorphous silicon-based full-field digital system (Senographe 2000 D, GE Healthcare, Chalfont St. Giles, UK). Images were independently analyzed by six board-certified radiologists. The probability of malignancy was estimated using first standard contact mammography alone (MG) and then mammography in combination with the magnification view (MG+MAG) using a modified Breast Imaging Reporting and Data System (BI-RADS) classification system and a percentage scale. Results were compared using receiver operating characteristic (ROC) analysis. In addition, readers assessed the subjective visibility of the calcifications.
Results: For all six readers combined, the area under the curve (AUC) was 0.664 ± 0.052 for MG and 0.813 ± 0.042 for MG + MAG, resulting in a statistically significant improvement of 0.148 ± 0.120. Each reader had a higher AUC for MG + MAG than MG, with the improvement being statistically significant in four of the six readers. In 76.34 % of the cases, MG + MAG resulted in better visibility of calcifications compared with mammography alone. In 33 % slightly more and in 39 % significantly more calcifications were found.
Conclusion: Even in digital mammography with the option of using electronic magnification (zoom) at the viewing workstation, true geometric (air-gap) magnification views remain important for the visibility and correct classification of microcalcifications and for the assessment of their extent.
Citation Format:
• Fallenberg EM, Dimitrijevic L, Diekmann F et al. Impact of Magnification Views on the Characterization of Microcalcifications in Digital Mammography. Fortschr Röntgenstr 2014; 186: 274 – 280
Zusammenfassung
Ziel: Evaluation des Nutzen geometrischer Vergrößerungsaufnahmen für die Charakterisierung von Mikroverkalkungen in der digitalen Mammografie.
Material und Methode: Nach positivem Ethikvotum selektierten wir retrospektiv anhand der Befundberichte 100 Patienten mit suspekten Mikroverkalkungen (35 maligne, 65 benigne), die innerhalb von 3 Monaten eine Standardmammografie (MG) und eine Vergrößerungsaufnahme (MAG) in der gleichen Ebene bekommen haben. Alle Aufnahmen wurden an einem Volldetektor-System (Senografe 2000 D, GE Healthcare, Chalfont St. Giles, UK) erstellt. Die Bilder wurden von 6 unabhängigen Radiologen analysiert. Die Malignitätswahrscheinlichkeit der MG alleine und dann folgend der MG plus MAG wurde bestimmt. Die Ergebnisse wurden mittels ROC-Analyse verglichen. Zusätzlich wurde die Sichtbarkeit der Verkalkungen beurteilt.
Ergebnisse: Die Area under curve (AUC) betrug für alle Reader kombiniert 0,664 ± 0,052 für MG und 0,813 ± 0,042 für MG + MAG, einer signifikante Verbesserung von 0,148 ± 0,120 entsprechend. Jeder Reader erreichte eine höhere AUC für MG + MAG als für MG, diese Verbesserung war bei vier Readern signifikant. In 76,34 % der Fälle zeigte MG + MAG eine bessere Sichtbarkeit der Kalzifikationen. Bei 33 % waren gering mehr, bei 39 % deutlich mehr Verkalkungen abgrenzbar.
Schlussfolgerung: Auch bei Einsatz der digitalen Mammografie mit den Möglichkeiten der elektronischen Vergrößerung bei Bildschirm-Befundung kann nicht auf geometrische Vergrößerungsaufnahmen verzichtet werden, da diese für die korrekte Klassifizierung und Ausdehnungsbeurteilung von Mikroverkalkungen weiterhin wichtig sind.
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