title: Characterization of microcalcification: can digital monitor zooming replace magnification mammography in full-field digital mammography?
abstract: The aim of this study was to compare the diagnostic accuracy and image quality of microcalcifications in zoomed digital contact mammography with digital magnification mammography. Three radiologists with different levels of experience in mammography reviewed 120 microcalcification clusters in 111 patients with a full-field digital mammography system relying on digital magnification mammogram (MAG) images and zoomed images from contact mammography (ZOOM) using commercially available zooming systems on monitors. Each radiologist estimated the probability of malignancy and rated the image quality and confidence rate. Performance was evaluated by sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic (ROC) analysis. All three radiologists rated MAG images higher than ZOOM images for sensitivity with statistical significance (average value, 92% vs. 87%, P<0.05) and performance by ROC analysis improved with MAG imaging. The confidence rate for diagnosis decision and the assessment of lesion characteristics were also better in MAG images than in ZOOM images with statistical significance (P<0.0001). Digital magnification mammography can enhance diagnostic performance when characterizing microcalcifications. Images zoomed from digital contact mammography cannot serve as an alternative to direct magnification digital mammography.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, 134 Shinchon-dong, Seodaemoon-gu, Seoul, South Korea, 120-752.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Kim
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Kim
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Kwak
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Son
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Youk
authors.forename: Seon Hyeong
authors.initials: SH
authors.lastname: Choi
authors.forename: Mooyoung
authors.initials: M
authors.lastname: Han
authors.forename: Ki Keun
authors.initials: KK
authors.lastname: Oh
mesh_terms: D001706:Biopsy; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis*; D002114:Calcinosis / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008327:Mammography / Q000379:methods*; D008495:Medical Oncology / Q000379:methods; D015233:Models, Statistical; D012372:ROC Curve; D011871:Radiology / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity