Detection of Microcalcifications in Women with Dense Breasts and Hypoechoic Focal Lesions: Comparison of Mammography and Ultrasound

Abstract

Purpose: Microcalcifications in the breasts can point to breast cancer. However, there is great morphologic variety, and microcalcifications do not always correlate with malignancy. We conducted a prospective study to compare ultrasound and mammography in the detection of microcalcifications following sonographic diagnosis of a hypoechoic focal lesion in women with dense breast composition. Materials and Methods: A total of 104 lesions potentially associated with microcalcifications (82 malignant and 23 benign lesions) were included in the study. The breast was examined by ultrasound (9?MHz, Aplio XG/500) with additional use of MicroPure imaging for the demonstration and evaluation of microcalcifications. The presence of a focal lesion was verified and microcalcifications were counted at ultrasound and mammography by blinded readers. The sensitivity and specificity were determined, and ROC analysis and AUC analysis were performed. Results: The women had a median age of 51 years. The average number of microcalcifications detected by sonography (2.12???2.77) and mammography (3.59???6.35) was not significantly different (p?>?0.05). Correlation of the techniques was adequate (Pearson?s r?=?0.616, p?<?0.0001; Spearman?s rho?=?0.654, p?<?0.0001). The intraclass correlation coefficient was K?=?0.382???0.072 (p?<?0.0001), also indicating adequate agreement of both techniques. The sensitivity and specificity were 70?%/30?% for MicroPure and 45?%/55?% for mammography. The positive predictive value of mammography was superior to that of MicroPure (88?% vs. 78?%). Conclusion: The sonographic detection of microcalcifications with MicroPure imaging in breasts with a hypoechoic focal lesion correlates well with digital mammography.

Evaluation of Diagnostic Accuracy of Ultrasound-Guided Semi-Automated Core Needle Biopsy of Breast Suspicious Microcalcifications

“…In the successful retrieval group, the mean number of cores containing calcification was 5.50 (range, 2-9). This result was agree with [11] that also found the total number of retrieved cores did not differ between groups.the mean was 6.5 (range, 4-9) in the successful retrieval group and was 7.3 (range, 6-10) in the failed retrieval group and in the successful retrieval group, the mean number of cores containing calcification was 4.8 (range, [1][2][3][4][5][6][7][8]. This study has some limitations.…”

“…Nevertheless, reliable sonographic identification of microcalcifications continues to be difficult, especially in dense breasts. This difficulty is attributable to the fact that collagen fibers, just likemicrocalcifications, are seen as bright foci [4] . With an improved sonographic detection of microcalcification, ultrasound could be used for biopsy guidance for target sampling of tissue containing microcalcifications.…”

“…With an improved sonographic detection of microcalcification, ultrasound could be used for biopsy guidance for target sampling of tissue containing microcalcifications. Ultrasound-guided breast biopsy is less expensive and does not involve radiation exposure, and it is more comfortable for the patient compared with stereotactic sampling as it does not require compression of the breasts [4] . Microcalcifications in malignant tumors are more likely to be detected by US than those in benign tumors because most malignant calcifications occur within the masses as opposed to within the echogenic breast parenchyma.…”

Multimodal ultrasound imaging: A method to improve the accuracy of diagnosing thyroid TI‐RADS 4 nodules

“…It is of great significance for the differential diagnosis of the nature of nodular lesions. 53 Although conventional ultrasound can detect some calcified foci, the detection rate decreases when calcification is too small (<2 mm) or covered by surrounding tissues. Microcalcification with a diameter of less than 2 mm is of great significance in the differentiation of benign and malignant thyroid nodules and is one of the important morphological features of thyroid papillary carcinoma.…”

Usability of Ultrasonic MicroPure Imaging for Evaluating the Vulnerability of Carotid Atherosclerotic Plaques

“…The ultrasonic MicroPure imaging technique is a new technique that processes ultrasonic images to improve the visualization of microcalcifications. 5,6 This method combines nonlinear imaging and speckle suppression to mark suspected calcifications as white spots in a blue overlay image. A microcalcification can be displayed as a flicker in a blue background, similar to fireflies fluttering on a dark night, so it is called "Firefly sign".…”