Computerized Image Analysis of Clustered Microcalcifications on Mammography: Morphome- tric Comparison between Mammography and Pathology.

The clusters of microcalcifications under 2 cm in greatest dimension were analyzed in terms of size and shape by an image processor with a computer after being magnified 33 times. The mean diameter of mammographic microcalcifications was 188 µ m in benign cases, 226µ m in cribriform or papillary type cancer cases, 213 µ m in intermediate type cancer cases, and 324µ m in comedo type cancer cases, showing significant differences among the groups. The size distribution of mammographic microcalcifications in the comedo type was characteristic, showing a second peak in distribution between 500 and 700µ m. The radiodensity of microcalcifications compared to the breast parenchyma, the caliber of breast ducts containing the malignant calcifications, and the unit volume of calcium deposits within the ductal lumens were greater in cancer cases. The size and shape of mammographic microcalcifications were considered to be related to a combination of the caliber of breast ducts, unit volume of calcium deposits within the ductal lumens, and the density of breast ducts containing calcium deposits. Duct calibers were generally larger in cases of cancer lesions than cases of benign lesions such as duct papillomatosis, thus calcium deposits and microcalcifications were greater in the cancer lesion. Uneven distrubution of size and form of microcalcifications over 250 µ m in size, and increased radiodensity of calcifications were useful parameters for differential diagnosis rather than the density of calcifications.