Eva Maria Fallenberg MD, Presenter: Travel support, Siemens AG Travel support, General Electric Company Speaker, Siemens AG Speaker, General Electric Company Speaker, BayerAG

Lisa Dimitrijevic, Abstract Co-Author: Nothing to Disclose

Felix Diekmann MD, Abstract Co-Author: Research grant, Bayer AG Research grant, General Electric Company Research grant, Sectra AB

Susanne Dorothea Diekmann MD, Abstract Co-Author: Nothing to Disclose

Diane Miriam Renz MD, Abstract Co-Author: Nothing to Disclose

Alexander Poellinger MD, Abstract Co-Author: Nothing to Disclose

Ute Ilona Kettritz MD, Abstract Co-Author: Nothing to Disclose

Ulrich Bick MD, Abstract Co-Author: Travel support, MeVis BreastCare GmbH & Co KG Travel support, Siemens AG Travel support, Hologic, Inc Travel support, Carestream Health, Inc Speaker, MeVis BreastCare GmbH & Co KG Speaker, Siemens AG Speaker, Hologic, Inc Speaker, Carestream Health, Inc

To evaluate the added benefit of true geometric (air-gap) magnification views for the characterization of microcalcifications in digital mammography.

Based on a retrospective review of the patient records, 100 patients with suspicious microcalcifications (35 malignant, 65 benign) were identified, which had an additional digital magnification view in the same projection (CC or MLO) and within a maximum period of three month as the original standard contact digital mammogram. All mammographic images were obtained using a amorphous silicon-based full-field digital mammography system (Senographe 2000D, GE Healthcare). All malignant cases and 34/65 of the benign cases were confirmed by vacuum-assisted or open biopsy, the remainder of the benign cases was confirmed by follow-up of at least 24 months. Images were analyzed independently by 6 Radiologists specialized in breast imaging using a dedicated mammography report workstation (syngo MammoReport, Siemens Medical Solutions) with all image manipulation features including electronic zoom and windowing available to the readers. The probability of malignancy was estimated first using standard contact mammography alone (Mx) and then in combination with the magnification view (Mx+MAG) using a modified BIRADS-Scale and a percentage scale. A ROC- analysis was performed using the LABMRMC program provided by the University of Chicago.  

For all 6 readers combined the Area under the curve (AUC) was 0.6773 for Mx and 0.8039 for Mx+MAG with a 95% confidence interval for the population mean difference of -0.26 to 0.0068 regarding the modified BIRADS-Scale. All individual readers had a higher AUC for Mx+MAG than Mx, with the improvement being statistically significant in three of the six readers.

Even in digital mammography with the possibility of electronic magnification (zoom) at the viewing workstation, true geometric (air-gap) magnification views remain important for the correct classification of microcalcifications.

As microcalcifications are often the only sign of DCIS the correct detection and assessment is important to detect very early stage breast cancer and reduce breast cancer mortality.

Fallenberg, E, Dimitrijevic, L, Diekmann, F, Diekmann, S, Renz, D, Poellinger, A, Kettritz, U, Bick, U, Impact of Magnification Views on the Characterization of Microcalcifications in Digital Mammography.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010324.html