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Feasibility Study for the Improvement of Microcalcification Visualization in Different Breast Thicknesses and Tissue Components Using a Dual-Energy Approach in Digital Mammography

Tsai, Chia-Jung PhD; Chen, Ran-Chou MD; Hung, Shuo-Hui PhD; Wu, Jay PhD; Peng, Hui-Ling MD; Lee, Jason J.S. PhD

Journal of Computer Assisted Tomography: July/August 2012 - Volume 36 - Issue 4 - p 488–494
doi: 10.1097/RCT.0b013e31825c83c4
CT and Digital Techniques

Objective The purpose of this study was to improve detectability of microcalcifications using a dual-energy digital mammographic (DEDM) technique.

Methods Slabs of uniform breast-equivalent plastic and an additional plate were used to mimic various breast thicknesses, from 3 to 7 cm, and to simulate microcalcification with diameters from 0.16 to 0.39 mm. Free-response receiver operating characteristics and area under the curves (Az) were used to evaluate the sensitivity of detecting microcalcifications using the DEDM compared with using the conventional single-energy digital mammography (SEDM).

Results The mean number of false-positives per image was 0.0198 (Az = 0.956 ± 0.027) using DEDM compared with 0.292 (Az = 0.681 ± 0.235) using SEDM. A lower radiation dose could be possibly obtained for the DEDM technique with a thickness of less than 5 cm compared with the SEDM with a thickness larger than 5 cm.

Conclusions Microcalcifications could be more accurately and efficiently detected using the DEDM, which might bring reliable and promising applications on early computer-aided diagnosis of breast cancer.

From the *Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University; Departments of †Radiology and ‡Surgery, Taipei City Hospital, Taipei; §Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung; and ∥Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

Received for publication February 3, 2012; accepted April 4, 2012.

Reprints: Ran-Chou Chen, MD, or Jason J.S. Lee, PhD, Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Department of Radiology, Taipei City Hospital, 155 Li-Nong St, Sec. 2, Taipei, Taiwan 112 (e-mail:;

This study was financially supported by the National Science Council of Taiwan (NSC99-2314-B-010-030-MY2).

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.