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Mammographic calcification may be the only sign of breast malignancy often requiring diagnostic biopsy. If visible, this calcification may be biopsied using ultrasound guidance or using X-ray guidance if not. Ultrasound biopsy is quicker, cheaper and more comfortable for the patient. Any technique that improves ultrasound calcification visualisation is desirable. MicroPure™ (Toshiba Medical Systems Corporation, Otawara, Japan) is a new ultrasound processing technology designed to achieve this.
We prospectively audited our experience of calcification detection with B-mode ultrasound and MicroPure™ between April and July 2010. Twenty-five women presenting with a dominant mammographic abnormality of calcification were studied. Targeted imaging with both techniques was performed with a Toshiba Aplio™ XG ultrasound machine using a 12 MHz linear probe. Technical support to optimise imaging was provided during our audit by Toshiba. We recorded ultrasound visibility with these two techniques and histological diagnosis.
Of 24 screening and one symptomatic woman examined, 11 (44%) were diagnosed with breast malignancy (six invasive cancers, four DCIS, one LCIS), and 14 (56%) were benign. Overall four (16%) (three malignant and one benign) calcifications were visualised by ultrasound. All were detectable using both B-mode and MicroPure™. Subjectively all four were felt to be more conspicuous using B-mode than MicroPure™.
Our initial experience has demonstrated MicroPure™ to be no better at detecting benign or malignant mammographic calcification than B-mode ultrasound. MicroPure™ would only be useful if it detects calcifications that are not visualised with B-mode ultrasound therefore reducing X-ray-guided biopsies.