Diagnosis of breast cancer based on microcalcifications using grating-based phase contrast CT
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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.
KeywordsBreast diseases Microcalcifications Grating-based phase-contrast CT ROC curves Youden index
This study has received funding by the National Natural Science Foundation of China (No. 11235007) and a Tsinghua University Independent Research Project Grant, “Research on Key Technologies and CT Reconstruction methods of multi-energy X-ray imaging”.
Compliance with ethical standards
The scientific guarantor of this publication is Zhiqiang Chen.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors, Shengping Wang, has significant statistical expertise.
Institutional Review Board approval was obtained.
Written informed consent was obtained from all subjects (patients) in this study.
• performed at one institution
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