Computer-Aided Detection of Amorphous Calcifications

Abstract

The CAD sensitivity for malignant amorphous calcifications is markedly lower than previously reported for all malignant calcifications. Breast imaging radiologists who use CAD systems should continue to search diligently for these difficult-to-detect lesions.

Usefulness and limitations of the Japan Mammography Guidelines for the categorization of microcalcifications

“…The rate of malignancy for amorphous microcalcifications is compatible with those reported by Berg et al [10] (20%), Soo et al [11] (16%) and Liberman et al [12] (26%). These results suggest that amorphous calcifications should be considered suspicious and referred for biopsy.…”

Evaluation of breast amorphous calcifications by a computer-aided detection system in full-field digital mammography

“…In our study, d-CAD marked 96% of the malignant-like group presenting as amorphous calcifications measuring 1-7 mm extent and 95% of the malignant-like group measuring .7 mm (Table 3), which is higher than published results for d-CAD [22] for this size of group, and marked higher than indirect CAD applied in amorphous calcifications [12] or slightly higher when considering all types of microcalcifications [24] for equivalent extension measurements.…”

“…We found a 29% risk of malignancy of the amorphous calcifications, and d-CAD detected 100% of the malignant cases or 96% of the malignant-like cases (breast cancer plus high-risk lesions). Berg et al [9] and Soo et al [12] found a 16-20% risk of malignancy in their series, and CAD case sensitivities by histological outcomes were found to be 57% for malignant calcifications, 29% for high-risk calcifications and 54% for benign calcifications. Their results are not akin to ours (100% for malignant calcifications, 85% for high-risk calcifications and 61% for benign calcifications) and this may represent the differences from using direct (our study) vs indirect CAD (with digitisation of images) systems.…”

“…Previous studies [12,[17][18][19] have shown that CAD sensitivity for the detection of breast cancer is similar in fatty breasts and dense breasts in both SFM [17] and FFDM [20][21][22][23]; however, indirect-CAD sensitivity for subgroups of cancers apparent only as microcalcifications has been shown to be higher in dense breasts than the sensitivity for calcifications in fatty breasts [12]. The indirect-CAD sensitivity was markedly lower in cases of malignant amorphous calcifications than in other malignant calcifications [12]. In our study, a similar trend was seen whereby d-CAD did not miss any cancers among fatty breasts; however, there were no statistically significant differences between dense and fatty breasts to correctly mark the malignant-like lesions.…”

“…In the field of CAD, the issue of reliability and reproducibility, which has been shown to be far from perfect in screen-film mammography (SFM) [2,13,14] as a result of mechanical scanning, virtually does not exist in FFDM since the mechanical process of scanning is avoided and CAD software is directly applied to the digital mammogram. Amorphous calcifications are frequently overlooked on SFM and can contribute to a substantial number of missed carcinomas [9,12,15,16]. Logically, the use of CAD systems that have superb sensitivity for the detection of malignant microcalcifications seems to be very attractive in digital mammography.…”