A comparison of conventional mammographic magnification, ultra high magnification and industrial magnification radiography in the radiographic detection of microcalcifications within core biopsies of the breast.

The objective was to compare conventional magnification radiography (CMR), ultra high magnification radiography (UHMR) and industrial magnification radiography (IMR) in the detection of microcalcifications in breast core biopsies. 440 core biopsies were examined in 1.8-fold CMR and in 7-fold UHMR using a prototype unit. A subgroup of 59 core biopsies were also examined in 10-fold IMR. Number, size, and demarcation of microcalcifications, as well as tissue contrast, were evaluated. Only 67% of the microcalcifications seen with UHMR were detected by CMR and 78% of the core biopsies showing calcifications in UHMR were calcified in CMR. Only 38% and 58% of microcalcifications verified by IMR were identified by CMR and UHMR, respectively. 47% and 63% of the core biopsies showing calcifications in IMR were calcified in CMR and UHMR, respectively. Tissue contrast of IMR was superior to both other modalities. On the other hand, increased cost and time will probably prohibit the use of IMR for specimen radiography in routine clinical examinations. In conclusion, UHMR identifies substantially more core biopsies with microcalcifications than CMR, thus potentially reducing the number of core biopsies needed for histological analysis. IMR allowed the detection of approximately 50%/160% more microcalcifications than UHMR/CMR, thus rendering it the reference mode.