Department of Engineering Physics, Tsinghua University, Haidian District, Beijing, China.
Key Laboratory of Particle and Radiation Imaging (Tsinghua University) of Ministry of Education, Haidian District, Beijing, China.
Eur Radiol. 2018 Sep;28(9):3742-3750. doi: 10.1007/s00330-017-5158-4. Epub 2018 Jan 26.
Microcalcifications are an important feature in the diagnosis of breast cancer, especially in the early stages. In this paper, a CT-based method is proposed to potentially distinguish benign and malignant breast diseases based on the distributions of microcalcifications using grating-based phase-contrast imaging on a conventional X-ray tube.
The method presented based on the ratio of dark-field signals to attenuation signals in CT images is compared with the existing method based on the ratio in projections, and the threshold for the classification of microcalcifications in the two types of breast diseases is obtained using our approach. The experiment was operated on paraffin-fixed specimens that originated from 20 female patients ranging from 27-65 years old.
Compared with the method based on projection images (AUC = 0.87), the proposed method is more effective (AUC = 0.95) to distinguish the two types of diseases. The discrimination threshold of microcalcifications for the classification of diseases in CT images is found to be 3.78 based on the Youden index.
The proposed method can be further developed to improve the early diagnosis and diagnostic accuracy and reduce the clinical misdiagnosis rate of breast cancer.
• Microcalcifications are of special importance to indicate early breast cancer. • Grating-based phase-contrast imaging can improve the diagnosis of breast cancers. • The method described here can better classify benign and malignant breast diseases.
微钙化是乳腺癌诊断的一个重要特征,尤其是在早期阶段。本文提出了一种基于 CT 的方法,利用常规 X 射线管上的光栅相衬成像,基于微钙化的分布,有可能区分良性和恶性乳腺疾病。
提出的基于 CT 图像中暗场信号与衰减信号比值的方法与现有的基于投影比值的方法进行了比较,并使用我们的方法获得了两种类型乳腺疾病中微钙化分类的阈值。该实验在石蜡固定标本上进行,标本来源于 20 名年龄在 27-65 岁之间的女性患者。
与基于投影图像的方法(AUC=0.87)相比,该方法在区分两种疾病方面更有效(AUC=0.95)。根据约登指数,发现 CT 图像中用于疾病分类的微钙化的判别阈值为 3.78。
该方法可进一步开发,以提高早期诊断和诊断准确性,降低乳腺癌的临床误诊率。
微钙化对提示早期乳腺癌具有特殊意义。
光栅相衬成像可以提高乳腺癌的诊断能力。
本文描述的方法可以更好地对良性和恶性乳腺疾病进行分类。