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11 April 1996 Digital mammography: an evaluation of the shape of microcalcifications
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Microcalcifications can be identified on mammograms in approximately 50 - 55% of breast cancer cases. Three factors affect the ability to use the presence of microcalcifications as a sign of cancer. They must be seen (conspicuity), their shape must be assessed (to differentiate benign and malignancy associated shapes) and they should be countable since the greater the number of clustered calcifications, the more likely they are malignancy associated. Concern has been expressed that digital systems with their inherently worse resolution would not allow adequate shape information to be captured. Using a 100 micron pixel size storage phosphor system we randomly selected 20 cases, 10 benign and 10 showing malignancy on biopsy and asked four radiologists to assess the calcifications present comparing the original screen film and the digital images and using the screen film biopsy specimen radiograph as ground truth. The preferences were mixed with some radiologists preferring screen film and others the digital images. Whatever their preferences, the radiologists were unable to use the shape criteria to distinguish benign and malignant cases in this case sample.
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Matthew T. Freedman M.D., Dorothy E. Steller Artz, Hamid Jafroudi, Jacquelyn Hogge M.D., Rebecca A. Zuurbier M.D., Raj Katial, Curtis E. Green, and Seong Ki Mun "Digital mammography: an evaluation of the shape of microcalcifications", Proc. SPIE 2708, Medical Imaging 1996: Physics of Medical Imaging, (11 April 1996);

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