Comparison of ^99m Tc-MIBI scintigraphy, ultrasound, and mammography for the diagnosis of BI-RADS 4 category lesions.

Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Breast Neoplasms/*diagnosis ; Carcinoma, Ductal, Breast/*diagnosis ; Carcinoma, Intraductal, Noninfiltrating/*diagnosis ; Magnetic Resonance Imaging/*methods ; Radionuclide Imaging/*methods ; Technetium Tc 99m Sestamibi/*metabolism ; Ultrasonography, Mammary/*methods; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/metabolism ; Carcinoma, Ductal, Breast/diagnostic imaging ; Carcinoma, Ductal, Breast/metabolism ; Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging ; Carcinoma, Intraductal, Noninfiltrating/metabolism ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Prognosis ; ROC Curve ; Radiopharmaceuticals/metabolism ; Retrospective Studies ; Young Adult

Background: We sought to determine the diagnostic efficacy of Breast-specific gamma imaging (BSGI) in Chinese women with BI-RADS 4 category lesions and to compare this efficacy to that of ultrasound/mammography.
Methods: We retrospectively analyzed data from 177 women that had undergone BSGI of BI-RADS 4 category lesions originally detected via ultrasound and/or mammography.
Results: Of these 177 cases, 117 (66.1%) were malignant lesions and 60 (33.9%) were benign. The sensitivity, specificity, positive predictive values, and negative predictive values of BSGI were 94.9% (111/117), 78.3% (47/60), 89.5% (111/124), and 88.7% (47/53), respectively. The specificity and positive predictive values for mammography were 48.3% (29/60) and 77.5% (107/138), while for ultrasound they were 53.3% (32/60) and 79.6% (109/137), respectively. The sensitivity and specificity of BSGI for the detection of lesions ≤1 cm in size were 90.9% (10/11) and 88.0% (22/25), respectively, while for breast lesions >1 cm in size these values were 94.3% (100/106) and 71.4% (25/35), respectively. In addition, BSGI sensitivity and specificity values for dense breast tissue were 94.0% (79/84) and 78.0% (39/50), respectively, whereas for non-dense breast tissue these vales were 97.0% (32/33) and 80.0% (8/10), respectively. The sensitivity of BSGI for invasive ductal carcinomas (IDC) and ductal carcinomas in situ (DCIS) was 98.9% (95/96) and 75.0% (9/12), respectively. The tumor to normal tissue ratio of BSGI for malignant lesions was significantly higher than for benign lesions (2.18 ± 1.17 vs 1.66 ± 0.40, t = 7.56, P<0.05).
Conclusions: These results indicate that BSGI is highly sensitive for the detection of such lesions, achieving good positive/negative predictive values. This suggests that for IDC in particular, BSGI is superior to ultrasound and mammography for the diagnosis of BI-RADS 4 category lesions, although this was less apparent for the diagnosis of DCIS lesions. BSGI exhibited excellent performance in dense breast tissue and for the detection of lesions ≤1 cm in size.

Invest Radiol. 1993 Mar;28(3):202-7. (PMID: 8486484)
BMC Cancer. 2016 Jul 11;16:450. (PMID: 27401536)
Br J Radiol. 2012 Jun;85(1014):e212-6. (PMID: 21712429)
JAMA Oncol. 2018 Nov 1;4(11):1553-1568. (PMID: 29860482)
Eur J Nucl Med Mol Imaging. 2013 Feb;40(3):450-63. (PMID: 23151912)
Cancer Biother Radiopharm. 2007 Dec;22(6):799-811. (PMID: 18158771)
Eur Radiol. 2013 Sep;23(9):2432-40. (PMID: 23673572)
Am J Surg. 2003 Jun;185(6):544-9. (PMID: 12781883)
AJR Am J Roentgenol. 2015 Feb;204(2):241-51. (PMID: 25615744)
J Natl Cancer Inst. 2006 Sep 6;98(17):1204-14. (PMID: 16954473)
Nucl Med Mol Imaging. 2013 Mar;47(1):18-26. (PMID: 24895504)
J Nucl Med Technol. 2009 Dec;37(4):201-5. (PMID: 19914975)
Int J Oncol. 2012 Aug;41(2):483-9. (PMID: 22641247)
Arch Surg. 2007 May;142(5):441-5; discussion 445-7. (PMID: 17515485)
AJR Am J Roentgenol. 2014 Feb;202(2):293-8. (PMID: 24450668)
Breast J. 2011 May-Jun;17(3):319-21. (PMID: 21492299)
J Nucl Med Technol. 2010 Dec;38(4):219-24. (PMID: 21057112)
Eur Radiol. 2017 Jul;27(7):2752-2764. (PMID: 27896471)
World J Radiol. 2016 Jun 28;8(6):610-7. (PMID: 27358689)
N Engl J Med. 2007 Jan 18;356(3):227-36. (PMID: 17229950)
J Nucl Med. 2012 Oct;53(10):1528-33. (PMID: 22911882)
Eur J Radiol. 2005 Feb;53(2):192-8. (PMID: 15664282)
Radiology. 1998 Nov;209(2):511-8. (PMID: 9807581)
AJR Am J Roentgenol. 2012 Jan;198(1):W69-75. (PMID: 22194518)
Ann Surg Treat Res. 2016 Apr;90(4):194-200. (PMID: 27073789)
N Engl J Med. 2005 Oct 27;353(17):1784-92. (PMID: 16251534)

Keywords: Breast cancer; Breast-specific gamma imaging/BSGI; Mammography; Ultrasound

0 (Radiopharmaceuticals)
971Z4W1S09 (Technetium Tc 99m Sestamibi)

Date Created: 20200526 Date Completed: 20210202 Latest Revision: 20210202

20231215

PMC7245809

10.1186/s12885-020-06938-7

32448217