What is the best imaging modality for detecting microcalcifications?

• A. Mammography
• B. Ultrasound
• C. MRI
• D. PET

Answer: (A)

Microcalcifications are tiny, high-contrast calcium deposits that require a radiograph with fine spatial resolution to be seen. Mammography uses low-dose X-rays and breast compression to produce sharp images of the ducts and surrounding tissue, making even very small calcifications appear as bright specks or clusters. This level of detail is not achievable with ultrasound, which excels at evaluating masses but cannot reliably resolve fine calcifications, especially in dense breasts. MRI focuses on soft-tissue contrast and enhancement and doesn’t reliably reveal calcifications, while PET detects metabolic activity rather than mineral deposits. Magnification views or digital/tomosynthesis mammography can further enhance visualization and characterization of calcifications.