Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. ORIGINAL RESEARCH n BREAST IMAGING 684 radiology.rsna.org n Radiology: Volume 259: Number 3—June 2011 Mammography with Synchrotron Radiation: First Clinical Experience with Phase-Detection Technique 1 Edoardo Castelli, PhD Maura Tonutti, MD Fulvia Arfelli, PhD Renata Longo, PhD Emilio Quaia, MD Luigi Rigon, PhD Daniela Sanabor, MD 2 Fabrizio Zanconati, MD Diego Dreossi, PhD Alessando Abrami, MS Elisa Quai, PhD Paola Bregant, PhD Katia Casarin, MS Valentina Chenda, MS Ralf Hendrik Menk, PhD Tatjana Rokvic, MS Alessandro Vascotto, MS Giuliana Tromba, PhD Maria Assunta Cova, MD Purpose: To prospectively evaluate the diagnostic contribution of mammography with synchrotron radiation in patients with questionable or suspicious breast abnormalities identified at combined digital mammography (DM) and ultrasonog- raphy (US). Materials and Methods: The ethics committee approved this prospective study, and written informed consent was obtained from all patients. Mammography with synchrotron radiation was performed with a phase-detection technique at a synchrotron radia- tion laboratory. Forty-nine women who met at least one of the inclusion criteria (palpable mass, focal asymmetry, architectural distortion, or equivocal or suspicious mass at DM; none clarified at US) were enrolled. Forty-seven women (mean age, 57.8 years 6 8.8 [standard deviation]; age range, 43–78 years) completed the study protocol, which involved biopsy or follow-up for 1 year as the refer- ence standard. Breast Imaging Reporting and Data System (BI-RADS) scores of 1–3 were considered to indicate a negative result, while scores 4–5 were considered to indi- cate a positive result. The visibility of breast abnormalities and the glandular parenchymal structure at DM and at mammography with synchrotron radiation was compared by using the Wilcoxon signed rank test. Results: In 29 of the 31 patients with a final diagnosis of benign entity, mammography with synchrotron radiation yielded BI-RADS scores of 1–3. In 13 of the remaining 16 patients with a final diagnosis of malignancy, mammography with synchrotron radiation yielded BI-RADS scores of 4–5. Therefore, a sensitivity of 81% (13 of 16 patients) and a specificity of 94% (29 of 31 patients) were achieved with use of the described BI-RADS dichotomization system. Conclusion: These study results suggest that mammography with syn- chrotron radiation can be used to clarify cases of ques- tionable or suspicious breast abnormalities identified at DM. q RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup /suppl/doi:10.1148/radiol.11100745/-/DC1 1 From the Departments of Physics (E.C., F.A., R.L., T.R.), Radiology (M.T., E. Quaia, D.S., M.A.C.), and Pathologic Anatomy (F.Z.), University of Trieste, Via A. Valerio 2, 34127 Trieste, Italy; National Institute of Nuclear Physics, Sezione di Trieste, Trieste, Italy (E.C., F.A., R.L., L.R., D.D., R.H.M., T.R.); Azienda Ospedaliero Universitaria “Ospedali Riuniti” di Trieste, Trieste, Italy (M.T., E. Quaia, D.S., F.Z., P.B., M.A.C.); Sincrotrone Trieste SCpA, Trieste, Italy (D.D., A.A., E. Quai, K.C., V.C., R.H.M., A.V., G.T.); and Faculty of Physics, University of Belgrade, Belgrade, Serbia (T.R.). Received April 12, 2010; revision requested May 26; revision received August 20; accepted October 6; final version accepted January 18, 2011. Supported by a grant from the Fondazione CRTrieste. Address correspondence to E.C. (e-mail: castelli@ts.infn.it ). 2 Current address: Ospedale Infantile Burlo Garofolo, Trieste, Italy. q RSNA, 2011