MALİGN MİKROKALSİFİKASYONLARIN DEĞERLENDİRİLMESİNDE DİJİTAL MAMOGRAFİ VE DİJİTAL MEME TOMOSENTEZİ BULGULARININ KARŞILAŞTIRILMASI

Amaç: Mamografide saptanan mikrokalsifikasyonların sayı, morfoloji ve dağılım özellikleri meme kanseririskini belirlemede kullanılan önemli kriterlerdir. Bu çalışmada şüpheli mikrokalsifikasyon bulunan ve memekanseri tanısı alan hastalarda dijital mamografi (DM) ve dijital meme tomosentez (DMT) incelemelerindemikrokalsifikasyonların sayı, morfoloji ve dağılım özelliklerinin karşılaştırılması amaçlandı.Gereç ve Yöntem: Çalışmaya şüpheli mikrokalsifikasyon saptanan ve meme kanseri tanısı alan 34 hastadahil edildi. Standart kranio-kaudal ve medio-lateral-oblik pozisyonda DM görüntüleri elde edildikten sonraşüpheli memeye medio-lateral-oblik pozisyonda DMT incelemesi yapıldı. Bu iki incelemede mikrokalsifikasyonlarınsayı (5-10, 10-20, >20), morfoloji (amorf, kaba heterojen, pleomorfik, lineer ve lineer dallanan) vedağılım (diffüz, bölgesel, grup, lineer, segmental) özellikleri karşılaştırıldı.Bulgular: 34 hastanın 29’unda (%85.2) mikrokalsifikasyonların sayı aralığı DM ve DMT incelemelerindebenzer iken 5 hastada (%14.7) DMT incelemesinde DM’ye göre daha az sayıda değerlendirilmiştir. 34 hastanın25’inde (%73.5) mikrokalsifikasyonların morfolojisi DM ve DMT incelemelerinde benzerdi. 34 hastanın29’inde (%85.2) mikrokalsifikasyonların dağılımı DM ve DMT incelemelerinde benzer bulundu. DM ve DMTincelemeleri arasında mikrokalsifikasyonların değerlendirilmesinde sayı açısından orta (κ=0.59), morfolojiaçısından iyi (κ=0.68), dağılım açısından mükemmel (κ=0.89) derecede uyum saptandı.Sonuç: Mikrokalsifikasyonların değerlendirilmesinde DM ile DMT incelemeleri arasında morfoloji ve dağılımaçısından uyum oranları, mikrokalsifikasyon sayısındaki uyum oranına göre daha yüksektir.

Comparison of Digital Mammography and Digital Breast Tomosynthesis Findings in Evaluation of Malignant Microcalcifications

Objective: The number, morphology and distribution features of microcalcifications detected on mammography are important criteria used for determination of breast cancer risk. The aim of this study was to compare the number, morphology and distribution features of microcalcifications on digital mammography (DM) and digital breast tomosynthesis (DMT) examinations in patients with suspected microcalcifications and diagnosed with breast cancer. Material and Method: Thirty-four patients who had suspected microcalcifications and were diagnosed with breast cancer were included the study. After DM images were obtained in standard cranio-caudal and medio-lateral-oblique position, DMT was performed in the medio-lateral-oblique position for suspicious breast. The number (5-10, 10-20, >20), morphology (amorphous, coarse heterogeneous, pleomorphic, linear and linear branching) and distribution (diffuse, regional, group, linear, segmental) properties of the microcalcifications were compared in these two examinations. Results: In 29 (85.2%) of 34 patients, the microcalcification number was similar in the DM and DMT examinations, while in 5 patients (14.7%) the DMT score was lower than DM. Morphology and distribution of microcalcifications were similar in the DM and DMT examinations in 25 (73.5%) and 29 (85.2%) of 34 patients, respectively. In the evaluation of microcalcifications, moderate agreement (κ = 0.59) for number, good agreement (κ = 0.68) for morphology and excellent agreement (κ = 0.89) for distribution were detected between the DM and DMT examinations. Conclusion: In the evaluation of microcalcifications, strength of agreement between DM and DMT examinations in terms of morphology and distribution are higher than strength of agreement for number of microcalcifications.

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