Zhentian Wang PhD, Abstract Co-Author: Nothing to Disclose

Nik Hauser MD, Abstract Co-Author: Nothing to Disclose

Gad Singer MD, Abstract Co-Author: Nothing to Disclose

Rahel A. Kubik-Huch MD, Abstract Co-Author: Nothing to Disclose

Marco Stampanoni PhD, Presenter: Nothing to Disclose

Microcalcifications are an important indicator in breast cancer diagnosis. Two kinds (Type I and Type II) of microcalcifications of different chemical composition are known to correlate with benign and malignant breast lesions. We developed a method (Nature Communications, in press) to distinguish among them in a non-invasive way. In this work we test the hypothesis that the positive predictive value of our method is about 2x larger than that of conventional mammography.

Phase contrast mammography using grating interferometry provides absorption, phase and small-angle scattering contrast of the breast simultaneously. Our microcalcification classification approach relies on the observation that Type I and Type II microcalcifications show opposite absorption and small-angle scattering signals. Compared with conventional mammography, the new approach reflects the internal crystal structure of the microcalcifications in addition to their morphological information. We are currently testing our hypothesis on biopsy samples (8 Gauge) of 20 patients (statistical power/significance of 0.8/0.05) referred for suspicious microcalcifications, classified as BIRADS-3 and -4, undergoing vacuum assisted breast Mammotome biopsy.

The new approach has 100% specificity and sensibility when applied to phantom data as shown in our recent work. At the RSNA, we will provide evidence of the solidity of the technique by statistically analyzing its discrimination power when applied to fixed tissue specimens.

We report a non-invasive approach to classify microcalcifications based on phase contrast X-ray imaging. The proposed method might be further developed to improve early breast cancer diagnosis and has the potential to increase the diagnostic accuracy and reduce the number of breast biopsies, or, in case of widespread microcalcifications, to select the optimal biopsy site before intervention.

Phase contrast X-ray imaging using Talbot-Lau grating interferometry can distinguish two types of microcalcification non-invasively, providing additional diagnostic hints for early breast cancer detection.

Wang, Z, Hauser, N, Singer, G, Kubik-Huch, R, Stampanoni, M, Non-invasive Microcalcification Classification Using X-ray Phase-contrast Mammography.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009119.html