19 April 2017 Classification of the micromorphology of breast calcifications in x-ray dark-field mammography
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The distant goal of this investigation is to reduce the number of invasive procedures associated with breast micro calcification biopsies, by improving and refining conventional BIRADS micro calcification assessments with x-ray dark-field mammography. The study was institutional review board (IRB) approved. A dedicated grating-based radiography setup (Mo-target, 40 keV, 70 mA) was used to investigate one breast mastectomy and 31 biopsies with dark-field mammography. Comparing the absorption and scattering properties of micro calcifications clusters enables accessing information on the interior morphology on the micron-scale retrieved in a non-invasive manner. Insights underlying the micro morphological nature of breast calcifications were verified by comprehensive high-resolution micro-CT measurements. It was found that Dark-field mammography allows a micro-structural classification of breast micro calcification as ultra-fine, fine, pleomorphic and coarse textured using conventional detectors. Dark-field mammography is thereby highly sensitive to minor structural deviations. Finally, the determined micro-texture of the investigated micro calcifications was correlated with findings obtained from histopathological work up. The presented results demonstrate that dark-field mammography yields the potential to enhance diagnostic validity of current micro calcification analysis - which is yet limited to the exterior appearance of micro calcification clusters - and thereby reduce the number of invasive procedures.
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Konstantin Willer, Kai Scherer, Eva Braig, Sebastian Ehn, Jonathan Schock, Johannes Wolf, Lorenz Birnbacher, Michael Chabior, Doris Mayr, Susanne Grandl, Aniko Sztrókay-Gaul, Karin Hellerhof, Maximilian Reiser, Franz Pfeiffer, Julia Herzen, "Classification of the micromorphology of breast calcifications in x-ray dark-field mammography", Proc. SPIE 10132, Medical Imaging 2017: Physics of Medical Imaging, 101325M (19 April 2017); doi: 10.1117/12.2255716; https://doi.org/10.1117/12.2255716

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