Types Of Microcalcifications Research Articles

Characterization of dolomite and calcite microcalcifications in human breast tissue.

Pathological crystallization within soft tissues often yields biominerals with properties differing from those of their geological or synthetic counterparts. Microcalcifications (MCs) are abundant in breast tumors, particularly in non-invasive lesions, such as ductal carcinoma in situ (DCIS). Given the challenge of predicting DCIS progression into invasive cancer, it has been suggested that MCs can be leveraged to inform DCIS prognosis. The predominant type of breast MCs are those containing calcium phosphates (CaP), whose crystal properties are commonly held to correlate with malignancy. Less common are non-CaP minerals, which have received less attention, as they are associated mainly with benign lesions. Here, we conducted a retrospective study of tissue samples collected from patients who were originally diagnosed with DCIS and whose current medical status is known. We examined the elemental composition, morphology, and crystal phases of 398 MCs, aiming to investigate potential correlations between MC crystal properties and the progression of DCIS. Our findings revealed primarily non-CaP MCs, an observation that was likely made possible only by the tissue processing methodology employed, which did not involve harsh conditions. We found that non-CaP MCs were abundant in DCIS lesions, that they exhibited diverse morphologies and sizes, and that they were composed of calcite and dolomite. Dolomite formation in cancer has not been reported previously and may be linked to pH fluctuations in the tumor microenvironment. The small size of DCIS lesions often requires pathologists to use the entire sample, thus reducing the number of samples available for further research. Nonetheless, despite our limited sample size, the observed trend indicated an association of dolomite MCs with DCIS lesions that progressed into invasive cancer over time.

Multicellular spheroids containing synthetic mineral particles: an advanced 3D tumor model system to investigate breast precancer malignancy potential according to the mineral type.

Mineral particles that form in soft tissues in association with disease conditions are heterogeneous in their composition and physiochemical properties. Hence, it is challenging to study the effect of mineral type on disease progression in a high-throughput and realistic manner. For example, most early breast precancer lesions, termed ductal carcinoma in situ (DCIS), contain microcalcifications (MCs), calcium-containing pathological minerals. The most common type of MCs is calcium phosphate crystals, mainly carbonated apatite; it is associated with either benign or malignant lesions. In vitro studies indicate that the crystal properties of apatite MCs can affect breast cancer progression. A less common type of MCs is calcium oxalate dihydrate (COD), which is almost always found in benign lesions. We developed a 3D tumor model of multicellular spheroids of human precancer cells containing synthetic MC analogs that link the crystal properties of MCs with the progression of breast precancer to invasive cancer. Using this 3D model, we show that apatite crystals induce Her2 overexpression in DCIS cells. This tumor-triggering effect is increased when the carbonate fraction in the MCs decreases. COD crystals, in contrast, decrease Her2 expression in the spheroids, even compared with a control group with no added MC analogs. Furthermore, COD decreases cell proliferation and migration in DCIS monolayers compared to untreated cells and cells incubated with apatite crystals. This finding suggests that COD is not randomly located only in benign lesions-it may actively contribute to suppressing precancer progression in its surroundings. Our model provides an easy-to-manipulate platform to better understand the interactions between mineral particles and their biological microenvironment. A better understanding of the effect of the crystal properties of MCs on precancer progression will potentially provide new directions for better precancer prognosis and treatment.

Dual energy-based quantification method for determination of breast microcalcification types

The purpose of this study is to distinguish and characterize breast microcalcification types (benign and malignant) non-invasively using photon-counting spectral mammography. In this study, a photon-counting spectral mammography system was simulated using Geant4 application for tomographic emission (GATE) tool. Based on the photon-counting detector, dual-energy images were obtained using two energy bins. Calcium oxalate and calcium hydroxyapatite were used for benign and malignant microcalcifications, respectively. As a quantitative characteristic evaluation for two types of microcalcification related to etiology, an analytical model was implemented for the determination of the calcium/phosphorus mass ratio (mCa/mP) based on the dual-energy method. In the chemical composition of each microcalcification, the calcium hydroxyapatite has a phosphate substance, and calcium oxalate has an oxalate substance. The thicknesses of the calcium oxalate corresponding to calcium hydroxyapatite were calculated to preserve equal photon beam attenuation. The results indicate a higher mass ratio value in the case of malignant microcalcifications when compared with that in the case of benign ones. Even when the breast thickness increased up to 5 cm, the difference in the mass ratio exhibited a constant tendency. By excluding the effect on x-ray attenuation properties, we confirmed that malignant and benign microcalcifications were quantitatively distinguished based only on the mineral properties of the chemical composition. In conclusion, this study provides quantitative and objective indicators, a non-invasive discrimination method of two types of microcalcifications associated with pathology. We also expect to reduce the frequency of biopsies by improving the accuracy of early diagnosis in mammography.

Histopathological correlation of punctate echogenic foci on ultrasonography in papillary thyroid carcinoma

To investigate the pathological entities of punctate echogenic foci (PEF) by correlating PEF with histopathological features of papillary thyroid carcinoma (PTC). This study included 121 consecutive patients who had undergone thyroidectomy for PTC. The inclusion criterion was entire tumor resection with a 3-mm thickness for histopathological examination. We assessed the presence and number (<5 or ≥5) of PEF defined as punctate hyperechoic foci within the solid component of nodules. All surgical tumor specimens were retrospectively reviewed for the presence of microcalcifications, including the psammomatous calcification, coarse microcalcification, and micro-ossification, and inspissated colloid. PEF were detected in 71 (58.7%) PTCs. Psammomatous calcifications, coarse microcalcifications, and inspissated colloids were more frequently found in PTCs with PEF than in those without (74.6%, 42.3%, and 46.5%, respectively, p ≤ 0.024). Any type of microcalcification was found in 90.1% of PTCs with PEF. Psammomatous calcifications, coarse microcalcifications, and inspissated colloids were independently associated with PEF (p ≤ 0.012). Psammomatous calcifications were found in all PTCs with a high number (≥5) of PEF. Microcalcifications were found in most PTCs with PEF and psammomatous calcification was the main pathological entity of PEF in PTC. Our study validates reliability of PEF as a predictor of microcalcifications in PTC.

Mammographic Microcalcifications and Breast Cancer: A Radio-Pathological Correlation

Background: Breast cancer is the most common cancer for women, often asymptomatic, and diagnosed from combined screening using mammography and ultrasound. Abnormal findings include microcalcifications with widely variable positive predictive values (PPVs) for malignancy, ranging from 2% to 95%. PPVs for each type of microcalcification are unknown. Objective: To assess PPVs for all abnormal microcalcifications in Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 as seen by mammography. Materials and Methods: The present study was a retrospective study of 62 female patients with abnormal microcalcifications that underwent mammography-guided needle localized excision between September 2011 and December 2018, at Thammasat University Hospital. Results: Of all 72 abnormal microcalcifications, PPVs were coarse heterogeneous 25%, amorphous 37.93%, fine pleomorphic 42.31%, and fine linear or linear branching 33.33%. Conclusion: Abnormal microcalcifications rated BI-RADS 4 or 5 have greatly varying malignancy risks, thus, tissue biopsies should be considered in line with microcalcification morphology and individual patient risk factors. Keywords: Breast cancer, Mammography, Microcalcification, Radio-pathologic correlation, Needle localized excision

The clinical value of detecting microcalcifications on a mammogram.

Many breast lesions are associated with microcalcifications that are detectable by mammography. In most cases, radiologists are able to distinguish calcifications usually associated with benign diseases from those associated with malignancy. In addition to their value in the early detection of breast carcinoma and accurate radiological diagnosis, the presence of microcalcifications often affects the extent of surgical intervention. Certain types of microcalcifications are associated with negative genetic and molecular characteristics of the tumor and unfavorable prognosis. Microcalcifications localized in the larger ducts (duct-centric, casting-type microcalcifications) represent an independent negative prognostic marker compared to lesions containing other types of microcalcifications and to non-calcified lesions. In this review, we summarize the theoretical and methodological background for understanding the clinical impact and discuss the diagnostic and prognostic value of microcalcifications detected in the breast by mammography.

Evaluation of photon-counting spectral mammography for classification of breast microcalcifications

The purpose of this study was to evaluate the feasibility of spectral mammography using a dual-energy method to non-invasively distinguish between type I (calcium oxalate) and type II (calcium hydroxyapatite) microcalcifications. These two types of microcalcifications are difficult to differentiate owing to their similar linear attenuation coefficients. To improve the detection efficiency regarding microcalcifications, a photon-counting detector with energy discrimination capability was used, and the microcalcifications were classified using the optimal dual-energy spectrum. Two energy bins were used to obtain dual-energy images. In this study, a photon-counting spectral mammography system was simulated using Geant4 Application for Tomographic Emission (GATE) simulation tools. A cadmium zinc telluride detector with a high quantum efficiency was used in this study. The effects of classification on the density and thickness of the breast phantom were investigated. Microcalcifications of various sizes, ranging from 130 to 550 μm, were embedded in the phantom. For statistical analysis, the microcalcifications were classified as calcium hydroxyapatite or calcium oxalate based on a score calculation using the dual-energy images. According to the results, the measured contrast-to-noise ratio (CNR) of the calcium hydroxyapatite was higher than that of calcium oxalate in a single-energy image. The calcium hydroxyapatite had a higher attenuation coefficient and slightly higher contrast compared with calcium oxalate. In addition, the microcalcifications were classified into the optimal energy bin in the dual-energy images. This classification showed better performance with a high energy of 50 kVp and an energy threshold of 30 keV. This study demonstrated that using the dual-energy method could improve classification performance because the microcalcifications are affected by the density and thickness of the breast phantom. These results indicate that the classification accuracy was improved when the difference between the low-energy image and high-energy image was used. The dual-energy method can reduce the frequency of the need for biopsies and discriminate between different types of microcalcifications in mammography. These results can improve the efficiency of early breast cancer diagnosis.

Breast Tumor Microcalcification Induced by Bone Morphogenetic Protein-2: A New Murine Model for Human Breast Tumor Diagnosis.

Widespread use of screening mammography has recently increased the detection of breast microcalcifications. These nonpalpable microcalcifications with specific features in breast tissues are clinically considered an early indicator of breast carcinoma. Our goal in this study was to develop a murine breast microcalcification model for optimizing in vivo imaging. Recombinant human BMP-2 was expressed in E. coli, and the purified bioactive protein was used as inducing factor for the production of breast microcalcifications in a murine animal model. Syngeneic breast tumors were obtained by injection of MDA-MB-231 human breast cancer cells with Matrigel into the mammary fat pad of female nude mice. Different doses of bioactive rhBMP-2 were administered either as single or multiple intraperitoneal injections or directly into tumor on a weekly basis. Three weeks after the first injection of rhBMP-2, the microcalcification of breast tumor was detected by microcomputed tomography followed by intravenous injection of radiotracer [18F] Sodium fluoride for positron emission tomography imaging. Our findings indicate that rhBMP-2 induced microcalcifications of breast tumor by both systemic and direct injection of rhBMP-2 into tumors in a dose-dependent manner. Although little is known about the molecular mechanism of microcalcification, here we report a new murine model of human breast tumor induced microcalcification by rhBMP-2 to optimize in vivo imaging methods and to study the role of BMP-2 as a mediator of pathological mineralization and bone-like microcalcification formation in breast tumor. This BMP-2-induced microcalcification model may allow us to discriminate the type of microcalcification in tumors and to perform quantitative analysis on the calcification as a new detection strategy for early identification of pathological mineralization of breast tissues in women.

Correlative Detection of Isolated Single and Multi-Cellular Calcifications in the Internal Elastic Lamina of Human Coronary Artery Samples

Histopathology protocols often require sectioning and processing of numerous microscopy slides to survey a sample. Trade-offs between workload and sampling density means that small features can be missed. Aiming to reduce the workload of routine histology protocols and the concern over missed pathology in skipped sections, we developed a prototype x-ray tomographic scanner dedicated to rapid scouting and identification of regions of interest in pathology specimens, thereby allowing targeted histopathology analysis to replace blanket searches. In coronary artery samples of a deceased HIV patient, the scanner, called Tomopath, obtained depth-resolved cross-sectional images at 15 µm resolution in a 15-minute scan, which guided the subsequent histological sectioning and microscopy. When compared to a commercial tabletop micro-CT scanner, the prototype provided several-fold contrast-to-noise ratio in 1/11th the scan time. Correlated tomographic and histological images revealed two types of micro calcifications: scattered loose calcifications typically found in atherosclerotic lesions; isolated focal calcifications in one or several cells in the internal elastic lamina and occasionally in the tunica media, which we speculate were the initiation of medial calcification linked to kidney disease, but rarely detected at this early stage due to their similarity to particle contaminants introduced during histological processing, if not for the evidence from the tomography scan prior to sectioning. Thus, in addition to its utility as a scouting tool, in this study it provided complementary information to histological microscopy. Overall, the prototype scanner represents a step toward a dedicated scouting and complementary imaging tool for routine use in pathology labs.

Characterization of Thyroid Nodule by Sonographic Features

Introduction: The thyroid is an endocrine gland situated in the infrahyoid compartment of neck in a space outlined by muscle, trachea, esophagus, carotid arteries and jugular veins. Though nodular thyroid disease is relatively common, thyroid cancer is rare and accounts for less than 1% of all malignancies indicating that overwhelming majority of thyroid nodules are benign. The purpose of this study was to assess the sonographic characteristics in a solitary thyroid nodule and predict risk of malignancy.Methods: This prospective study was conducted in a tertiary care hospital in Kathmandu.62 patients with palpable thyroid nodule were evaluated for sonographic characteristics .USG guided FNA for cytopathological examination was then performed.Results: Out of 66 patients, four were subsequently excluded because they didn’t fulfill the inclusion criteria. Of the 62 patients, 47 (75.8%) were females and 15 (24.2%) were males. Among 56 benign nodules, 45 (80.4%) were in females and 11(19.6) were in male. Among 6 malignant nodules, 4(66.7%) were in males and 2 (33.3%) were in females. Result shows 5 malignant nodules (83.3%) were solid where as 1 malignant nodule (16.7%) was complex with solid predominance. All 4 cystic nodules (7.1%) were benign. All complex nodules with predomint cystic components were also benign. One malignant nodule (16.7%) had snow storm type of microcalcification. None of the benign nodules had microcalcification. Nodule having microcalcification was malignant. Findings showed that all malignant nodules (100%) had increased internal vascularity whereas benign nodules were variable in internal vascularity.Conclusion: This study has shown that colloid goiter is the commonest benign diagnosis whereas papillary carcinoma is the commonest malignancy. Malignant nodules are solid or predominantly solid whereas cystic and predominantly cystic nodules are likely to be benign. Macrocalcification and internal vascularity are not reliable to differentiate benign from malignant nodule. However, snowstorm calcification makes a nodule likely to be malignant whereas egg shell calcification is characteristic for benign nodule.

A Micro CT Study in Patients with Breast Microcalcifications Using a Mathematical Algorithm to Assess 3D Structure.

PurposeThe aim of this study was to evaluate the relevance of the three-dimensional (3D) structure of breast microcalcifications (MC) as a predictor of malignancy using highly resolved micro-computed tomography (micro-CT) datasets of biopsy samples.Material and MethodsThe study included 28 women with suspicious MC in their mammogram undergoing vacuum-assisted biopsy. Directly after the intervention, the specimens were scanned in a micro-CT with an isometric spatial resolution of 9 μm. Datasets were analysed regarding the number, volume and morphology of suspicious non-monomorphic MC (fl—fine linear, fp—fine pleomorphic, ch—coarse heterogeneous) and the structure model index (SMI). Histological evaluation was performed according to the B-classification: normal tissue or benign (group A: B1, B2), unclear malignant potential or suspicious of malignancy (group B: B3, B4) and malignant lesions (group C: B5).ResultsIn all groups, suspicious non-monomorphic MC were found: group A exhibited fp MC in 38.5% of samples, no fl/ch; group B: fl 14.3%, fp 28.6%, ch 14.3%; group C always had at least one type of suspicious non-monomorphic MC (fl (57.1%) or fp (57.1%)) in each sample. The different histologic groups showed a similar mean SMI (benign: 2.97 ± 0.31, malignant: 3.02 ± 0.10, unclear: 2.90 ± 0.28). Between the three groups, no significant differences were found regarding number, volume or SMI value of MC.Conclusion3D structure based on the SMI of MC analysed with highest spatial resolution is not significantly associated with the B-classification of breast lesions. Thus, magnification views of MC may be omitted in the analysis of MC detected in mammograms.

Non-invasive classification of breast microcalcifications using x-ray coherent scatter computed tomography

We investigate the use of energy dispersive x-ray coherent scatter computed tomography (ED-CSCT) as a non-invasive diagnostic method to differentiate between type I and type II breast calcifications. This approach is sensitive to the differences of composition and internal crystal structure of different types of microcalcifications. The study is carried out by simulating a CSCT system with a scanning pencil beam, considering a polychromatic x-ray source and an energy-resolving photon counting detector. In a first step, the multidimensional angle and energy distributed CSCT data is reduced to the projection-space distributions of only a few components, corresponding to the expected target composition: adipose, glandular tissue, weddellite (calcium oxalate) for type I calcifications, and hydroxyapatite for type II calcifications. The maximum-likelihood estimation of scatter components algorithm used, operating in the projection space, takes into account the polychromatic source, the detector response function and the energy dependent attenuation. In the second step, component images are reconstructed from the corresponding estimated component projections using filtered backprojection. In a preliminary step the coherent scatter differential cross sections for hydroxyapatite and weddellite minerals were determined experimentally. The classification of type I or II calcifications is done using the relative contrasts of their components as the criterion. Simulation tests were carried out for different doses and energy resolutions for multiple realizations. The results were analyzed using relative/receiver operating characteristic methodology and show good discrimination ability at medium and higher doses. The noninvasive CSCT technique shows potential to further improve the breast diagnostic accuracy and reduce the number of breast biopsies.

TH-AB-209-11: Breast Microcalcification Classification Using Spectral X-Ray Coherent Scatter Computed Tomography

Purpose: To investigate the ability of Coherent Scatter Computed Tomography (CSCT) to distinguish non-invasively between type I calcifications, consisting of calcium oxalate dihydrate (CO) compounds which are more often associated with benign lesions, and type II calcifications containing hydroxyapatite (HA) which are predominantly associated with malignant tumors. Methods: The coherent scatter cross sections of HA and CO were measured using an energy dispersive x-ray diffractometer. The measured cross sections were introduced into MC-GPU Monte Carlo simulation code for studying the applicability of CSCT to discriminate between the two types of microcalcifications within the whole breast. Simulations were performed on a virtual phantom with inserted HA and CO spots of different sizes and placed in regions of interest having different background compositions. We considered a polychromatic x-ray source and an energy resolving photon counting detector. We applied an algorithm that estimates scatter components in projection space in order to obtain material-specific images of the breast. As material components adipose, glandular, HA and CO were used. The relative contrast of HA and CO components were used for type I and type II microcalcification discrimination. Results: The reconstructed CSCT images showed material-specific component-contrast values, with the highest CO or HA component contrast corresponding generally to the actual CO or HA feature, respectively. The discrimination performance varies with the x-ray intensity, calcification size, and background composition. The results were summarized using receiver operating characteristic (ROC) analysis with the area under the curve (AUC) taken as an overall indicator of discrimination performance and showing high AUC values up to unity. Conclusion: The simulation results obtained for a uniform breast imaging phantom indicate that CSCT has potential to be used as a non-invasive method for discrimination between type I and type II microcalcifications.

Screen-detected ductal carcinoma in situ found on stereotactic vacuum-assisted biopsy of suspicious microcalcifications without mass: radiological-histological correlation.

BackgroundCommonly identified on screening mammography breast microcalcifications are the predominant manifestation of ductal carcinoma in situ (DCIS). The aim of this study was to investigate the association between clinico-radiological features and histological findings in patients with screen-detected DCIS.Patients and methodsConsecutive 127 patients with pure DCIS found on stereotactic vacuum-assisted biopsy of screen-detected suspicious microcalcifications without mass entered the study. Patient age, type and distribution of microcalcifications, DCIS nuclear grade (NG) and the presence of comedonecrosis were investigated. Association between parameters was statistically analysed with P < 0.05 as a significance level. Results. Powdery microcalcifications were most often clustered while regional were most common of casting-type (P < 0.001). High, intermediate and low NG of DCIS was significantly related to casting-type, crushed stone-like and powdery microcalcifications, respectively (P < 0.01). Low and intermediate NG DCIS were the most common in clustered and grouped microcalcifications while high NG DCIS was the most often when regional distribution was observed (P < 0.05). Comedonecrosis was significantly more common in high NG DCIS (P < 0.01). The association between comedonecrosis and type of microcalcifications was not significant, but with their distribution was close to the significance level (P = 0.07). Patient age was not significantly related to imaging or histological findings.ConclusionsThe association between pattern of mammographic microcalcifications and histological findings related to more aggressive disease can be helpful in optimal surgery planning in patients with screen-detected DCIS, regarding the extent of breast intervention and consideration of synchronous sentinel node biopsy.

Columnar cell lesions of the breast: radiological features and histological correlation

This study aimed at investigating the characteristic imaging findings of the columnar cell lesions (CCLs) of the breast via mammography (MG), ultrasonography (US), and magnetic resonance imaging (MRI). The MG, US and MRI findings of 72 patients with histopathological diagnosis of CCLs were retrospectively evaluated. Histopathologically, the CCLs were divided into those with and without atypia; the radiological findings of these two groups were compared with a Chi-square test. Sixty-nine patients underwent stereotaxic biopsy (MG-guided in 50 patients and US-guided in 19 patients) and 3 patients underwent US-guided core needle biopsy; all of these patients were diagnosed with CCLs based on a histological examination. The evaluation of the CCLs in patients that underwent MG-guided stereotaxic biopsy revealed that the most common type of microcalcifications were amorphous-indistinct (52%, n= 26/50) and the most common microcalcification distribution pattern was clustered type (76%, n= 38/50). The ratio of CCLs with atypia was similar in patients with high-risk microcalcifications and in those with benign or intermediate-risk microcalcifications (OR: 1.13, 95% CI: 0.573-2.227, p: 0.475). On the other hand, those patients who underwent US-guided biopsies for the evaluation of CCLs had similar proportions of cystic or solid lesions, posterior acoustic shadowing and contour irregularities whether or not they had atypia (p: 0.584, 0.075, 0.187, respectively). Patients with atypia had a higher number of lesions greater than 1 cm via US as compared to those without atypia, but this difference was not statistically significant (p: 0.06). MRI findings were also similar in patients with and without atypia. MG revealed that clustered distribution patterns and amorphous- indistinct type microcalcifications were more commonly seen in patients with CCLs; however, there was no significant relationship between US or MRI findings and CCLs. In addition, the MG, US and MRI findings were similar in patients with CCLs that did or did not have histopathological characteristics of atypia.

Mammographic calcifications in women in Ibadan, South-West Nigeria: A seven years review

Background/Aims: The purpose of this paper is to present the various types of calcifications seen on mammograms in Nigerian women in Ibadan. The study was to describe calcifications using the American College of Radiology Breast Imaging Reporting and Data System (ACR-BIRADS) classification, document the incidence of the various types of calcifications in a Nigerian population and also report on any association between these calcifications and the demographic variables. Materials and Methods: A prospective study of 894 mammograms done in the Radiology Department of the University College Hospital, Ibadan over a seven year period (2006–2013). The mammographic evaluation was carried out by two radiologists. Calcifications were described and classified using the ACR-BIRADS system. Patients' demographic data were obtained using the departmental breast imaging questionnaire. Results: Of the 894 women (with an age range of 30–82 years), 213 (23.8%) had calcifications on their mammograms. Macro-calcifications (81.2%) were more common than micro-calcifications (18.8%). The most common distribution of these calcifications was the clustered type. Vascular calcifications (31.2%) were the common morphologic type of macro-calcifications while the punctate calcifications (15.5%) were the common morphologic type of micro-calcifications. About 12.3% of the women had associated masses, 3.3% had associated asymmetric density and 1.9% had associated architectural distortion. A quarter of micro-calcifications fell under 'higher probability of malignancy' (BIRADS 3) and 39% fell under 'intermediate concern of malignancy' (BIRADS 2). 18.4% of the women were asked to undergo further imaging studies. Conclusion: We have reported the various types, distributions and morphology of calcifications seen in an African population, similar to those seen in developed countries.

CLASSIFICATION OF MICROCALCIFICATION BASED ON WAVE ATOM TRANSFORM

Breast cancer is a serious problem for women in the world. It is the most common form of cancer diagnosed in woman, with one in nine women expected to be diagnosed with some form of cancer in their life-time. It is second only to lung cancer in cancer related deaths. Statistics shows that the case of breast cancer in the world is increasing every year. By analyzing a mammogram, pathologists could detect the presence of microcalcification in ones breast. However, microcalcification can be classified into benign and malignant. The later indicates the presence of cancer. Computer-Aided Diagnosis (CADx) designed to help phatologists determine the type of microcalcification in a mammogram. Usually, it's consisting of two steps, feature extraction and classification. In our methodology, we proposed the use of Wave Atom Transform (WAT) as feature extraction technique and Support Vector Machine (SVM) as classifier. Using this methodology, our experimental result achieved good classification accuracy. However, some of the previous researches have shown better results than ours.

Non-invasive classification of microcalcifications with phase-contrast X-ray mammography.

Microcalcifications can be indicative in the diagnosis of early breast cancer. Here we report a non-invasive diagnostic method that may potentially distinguish between different types of microcalcifications using X-ray phase-contrast imaging. Our approach exploits the complementary nature of the absorption and small-angle scattering signals of microcalcifications, obtained simultaneously with an X-ray grating interferometer on a conventional X-ray tube. We demonstrate that the new approach has 100% sensitivity and specificity when applied to phantom data, and we provide evidence of the solidity of the technique by showing its discrimination power when applied to fixed biopsies, to non-fixed tissue specimens and to fresh, whole-breast samples. 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 uncomfortable breast biopsies, or, in case of widespread microcalcifications, to select the biopsy site before intervention.

Simulation of dark-field imaging of micro-calcifications in human breast tissue with X-ray Talbot-Lau interferometry

A simulation of dark-field imaging of sub-resolution structures with X-ray Talbot-Lau interferometry is presented. Data obtained from the simulation shows good agreement to a signal found in the dark-field image of a surgically removed sample of human breast tissue containing micro calcifications. A measure for the type of micro calcifications is introduced which can be calculated from dark-field signals. In a further analysis of the simulated data, it can be shown that the measure can be used to discriminate between different calcifications types.

Breast microcalcifications: The lesions in anatomical pathology

Microcalcifications are actually indirect signs of pathological processes, and only a few of these processes may be correctly correlated to the morphologic pattern of calcifications. This is true of the microcalcifications typically classified as benign by the 4th edition of the BI-RADS Atlas, except for round and punctuate microcalcifications. This is also the case of polymorphous fine and linear fine microcalcifications most often, but not exclusively, associated with DCIS with necrosis. For other types of microcalcifications, other parameters are analyzed in a more global approach: the associated clinical or mammographical signs; the context, especially genetic; the spatial distribution; the number; the evolution over time. The radiologist should compare the images with the anatomy of the terminal ductal-lobular unit, from where most cancers arise, and estimates the risk by taking into account the clinical context and the antecedents.