Does residual ultrasound transmission gel affect the diagnostic ability of mammography?

This study aimed to assess whether residual ultrasound transmission gel (USTG) caused artifacts in mammography using a model 156 mammographic accreditation phantom and step phantom. Moreover, pig tissues with structures similar to those of the breast were imaged to assess whether USTG on the tissue appeared as a shadow on the mammogram, and how these shadows may be interpreted in clinical practice. The results showed that the visualization scores obtained for phantom mammograms decreased significantly for the fiber and mass samples after the application of USTG. Moreover, USTG on the tissues affected the visual evaluation of mammograms, leading to misinterpretation of mammographic findings.

[The Influence on Image Reconstruction Methods on Digital Breast Tomosynthesis Guided Vacuum-assisted Biopsy for Clustered Microcalcifications].

In this study, we verified the targeting time and coordinates of stereotactic vacuum-assisted biopsy (STVAB) and digital breast tomosynthesis-guided vacuum-assisted biopsy (DBTVAB). We used 23 fabricated phantom samples that consisted of small round, amorphous, and pleomorphic clustered microcalcifications, and two types of image reconstruction methods: filtered back projection (FBP) and iterative super-resolution reconstruction (ISR). Regarding targeting time, DBTVAB tended to be shorter than STVAB in the two image reconstruction methods and the targeting time was significantly shorter for the amorphous and pleomorphic calcifications using DBTVAB with FBP compared to that using STVAB (p=0.022 for amorphous, p=0.041 for pleomorphic). The targeting time for small round calcifications was longer using DBTVAB with ISR compared to that using STVAB (p=0.013). For targeting coordinates, using DBTVAB with FBP showed a significant difference only for pleomorphic calcifications but using DBTVAB with ISR showed no significance. The findings of this study suggest that FBP is more suitable than ISR to be used as an image reconstruction method, and DBTVAB can shorten the targeting time compared to STVAB.

Can digital breast tomosynthesis improve identification of malignant calcifications?

Digital breast tomosynthesis (DBT) is an emerging imaging tool for both the screening and diagnosis of breast cancers. However, the use of DBT in diagnosis of calcifications remains ambiguous. In this study, we investigated DBT findings that might help differentiate between benign and malignant calcifications. We enrolled 256 subjects and evaluated 303 breasts with grouped or segmental calcifications. All imaging examinations were performed using two-directional full-field digital mammography (FFDM) and DBT. We divided subjects into two groups, namely, "dense" and "fatty," based on the quantity of breast tissue and evaluated whether the growth of cancer causes increased the density overlapping with calcifications. Increased overlapping density was significantly associated with malignant calcifications (p < 0.001), and the identification of increased density was more accurate using DBT than using FFDM. Furthermore, we used DBT to evaluate whether segmental calcifications were continuous or discontinuous. Significantly more malignant than benign calcifications were associated with a continuous distribution (p = 0.035). Increased density overlapping with grouped calcifications was significantly associated with invasive cancers (p = 0.017). The findings of this study suggest that DBT improves the ability to differentiate between benign and malignant calcifications.