Abstract:Accurate characterization of microcalcifications (MCs) in 2D full-field digital screening mammography is a necessary step towards reducing diagnostic uncertainty associated with the callback of women with suspicious MCs. Quantitative analysis of MCs has the potential to better identify MCs that have a higher likelihood of corresponding to invasive cancer. However, automated identification and segmentation of MCs remains a challenging task with high false positive rates. We present Hessian Difference of Gaussians Regression (HDoGReg), a two stage multi-scale approach to MC segmentation. Candidate high optical density objects are first delineated using blob detection and Hessian analysis. A regression convolutional network, trained to output a function with higher response near MCs, chooses the objects which constitute actual MCs. The method is trained and validated on 435 mammograms from two separate datasets. HDoGReg achieved a mean intersection over the union of 0.670$\pm$0.121 per image, intersection over the union per MC object of 0.607$\pm$0.250 and true positive rate of 0.744 at 0.4 false positive detections per $cm^2$. The results of HDoGReg perform better when compared to state-of-the-art MC segmentation and detection methods.