Ultraschall Med 2013; 34 - WS_SL18_03
DOI: 10.1055/s-0033-1354914

Sonographic detection of microcalcifications – potential of new method

A Thomas 1, M Grigoryev 2, S Bossenz 1, F Dieckmann 2, U Bick 2, T Slowinski 3, T Fischer 2
  • 1Charité – Universitätsmedizin Berlin, Department of Obstetrics and Gynaecology and Ultrasound Research Laboratory, Berlin, Germany
  • 2Charité – Universitätsmedizin Berlin, Institut of Radiology and Ultrasound Research Laboratory, Berlin, Germany
  • 3Charité – Universitätsmedizin Berlin, Department of Nephrology, Berlin, Germany

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

Material 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 ρ were performed. Intraclass correlation coefficient (ICC) was calculated, and a 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 histologic 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.