Breast-specific gamma imaging as an adjunct imaging modality for the diagnosis of breast cancer
Breast-specific gamma imaging as an adjunct imaging modality for the diagnosis of breast cancer
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DOI：
10.1148/radiol.2473061678
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发表时间：
2008-06-01
期刊：
影响因子：
19.7
通讯作者：
Mathur, Vivek
中科院分区：
文献类型：
--
作者：
Brem, Rachel F.;Floerke, Angelique C.;Mathur, Vivek
目的：以乳腺特异性伽马成像（breast-specific gamma imaging， BSGI）的病理结果为参考标准，回顾性确定其检测乳腺癌的敏感性和特异性。材料和方法：本研究经机构审查委员会批准，并符合《健康保险流通与责任法案》。未作为临床方案一部分成像但参与其他机构审查委员会批准的使用BSGI的研究的参与者获得知情同意。我们对146名接受BSGI和乳腺活检的女性（32-98岁）进行了回顾性研究。患者接受BSGI，静脉注射30 mCi （1110 MBq）锝99 (Tc-99m)-sestamibi，并在颅侧和中外侧斜位投影上成像。研究图像被分配评分，评分分为阳性（局灶性放射性示踪剂摄取增加）或阴性（无摄取或分散异质生理摄取），并与活检结果进行比较。测定其敏感性、特异性、阳性预测值和阴性预测值。结果：146例患者167个病灶行活检，其中83例为恶性（DCIS 16例，浸润性癌67例）。84例非恶性病变中，82例为良性，2例表现为非典型组织学结果（1例非典型小叶增生，1例小叶原位癌）。BSGI帮助检测83个恶性病变中的80个肿瘤，灵敏度为96.4%(95%置信区间[CI]: 92%， 99%)，正确识别84个非恶性病变中的50个肿瘤阴性，特异性为59.5% （95% CI: 49%, 70%）。114例BSGI检查中癌阳性的恶性病变中有80例阳性预测值为68.8% (95% CI: 60%, 78%)， 53例非恶性病变中有50例阴性预测值为94.3% （95% CI: 88%, 99%）。最小浸润性癌和DCIS均为1mm。BSGI帮助6例患者发现乳腺x光检查或超声检查未发现的隐匿性肿瘤。结论：BSIG检测乳腺癌具有较高的灵敏度（96.4%）和中等的特异性（59.5%）。(c) rsna， 2008年。
Purpose: To retrospectively determine the sensitivity and specificity of breast-specific gamma imaging (BSGI) for the detection of breast cancer by using pathologic results as the reference standard.Materials and Methods: This study was Institutional Review Board approved and Health Insurance Portability and Accountability Act compliant. Informed consent was obtained for participants who were not imaged as part of their clinical protocol but were participating in other Institutional Review Board approved studies that used BSGI. A retrospective review of 146 women (aged 32-98 years) undergoing BSGI and breast biopsy was performed. Patients underwent BSGI with intravenous injection of 30 mCi (1110 MBq) of technetium 99 (Tc-99m)-sestamibi and were imaged in craniocaudal and mediolateral oblique projections. Study images were assigned scores, and scores were classified as positive (focal increased radiotracer uptake) or negative (no uptake or scattered heterogeneous physiologic uptake) and compared with biopsy results. The sensitivity, specificity, and positive and negative predictive values were determined.Results: In 146 patients, 167 lesions underwent biopsy, of which 83 (16 ductal carcinoma in situ [DCIS] and 67 invasive cancers) were malignant. Of 84 nonmalignant lesions, 82 were benign and two showed atypical histologic results (one atypical lobular hyperplasia and one lobular carcinoma in situ). BSGI helped detect cancer in 80 of 83 malignant lesions with a sensitivity of 96.4% (95% confidence interval [CI]: 92%, 99%) and correctly identified 50 of 84 nonmalignant lesions as negative for cancer with a specificity of 59.5% (95% CI: 49%, 70%). The positive predictive value for 80 of 114 malignant lesions with a BSGI examination with findings positive for cancer was 68.8% (95% CI: 60%, 78%) and the negative predictive value for 50 of 53 nonmalignant lesions was 94.3% (95% CI: 88%, 99%). The smallest invasive cancer and DCIS detected were both 1 mm. BSGI helped detect occult cancer not visualized at mammography or ultrasonography in six patients.Conclusion: BSIG has high sensitivity (96.4%) and moderate specificity (59.5%) helping detect breast cancers. (C) RSNA, 2008.