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Willer, Konstantin, Scherer, Kai, Braig, Eva, Ehn, Sebastian, Schock, Jonathan, Wolf, Johannes, Birnbacher, Lorenz, Chabior, Michael, Mayr, Doris, Grandl, Susanne, Sztrókay-Gaul, Aniko, Hellerhoff, Karin, Reiser, Maximilian, Pfeiffer, Franz and Herzen, Julia (2017): Classification of the Micromorphology of Breast Calcifications in X-ray Dark-Field Mammography. In: Medical Imaging 2017: Physics of Medical Imaging, Vol. 10132, 101325M

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The distant goal of this investigation is to reduce the number of invasive procedures associated with breast micro calcification biopsies, by improving and refining conventional BIRADS micro calcification assessments with x-ray dark-field mammography. The study was institutional review board (IRB) approved. A dedicated grating-based radiography setup (Mo-target, 40 keV, 70 mA) was used to investigate one breast mastectomy and 31 biopsies with dark-field mammography. Comparing the absorption and scattering properties of micro calcifications clusters enables accessing information on the interior morphology on the micron-scale retrieved in a non-invasive manner. Insights underlying the micro morphological nature of breast calcifications were verified by comprehensive high-resolution micro-CT measurements. It was found that Dark-field mammography allows a micro-structural classification of breast micro calcification as ultra-fine, fine, pleomorphic and coarse textured using conventional detectors. Dark-field mammography is thereby highly sensitive to minor structural deviations. Finally, the determined micro-texture of the investigated micro calcifications was correlated with findings obtained from histopathological work up. The presented results demonstrate that dark-field mammography yields the potential to enhance diagnostic validity of current micro calcification analysis - which is yet limited to the exterior appearance of micro calcification clusters - and thereby reduce the number of invasive procedures.

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