Comparison of 99mTc-Sestamibi Scintimammography and Dynamic MR Imaging as Adjuncts to Mammography in the Diagnosis of Breast Cancer

Boné, B.; Wiberg, Maria Kristoffersen; Szabó, Botond K.; Szakos, Attila; Danielsson, Rimma

doi:10.1034/j.1600-0455.2003.00012.x

Cited by 13 publications

(11 citation statements)

References 13 publications

(17 reference statements)

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“…The overall sensitivity of MRI in this 14-site investigation was within the range reported for large, single-center studies (range, 88%-95%), [5][6][7][8][9][10]14,15 albeit at the lower end of the spectrum. A multicenter study of 463 patients reported a sensitivity of 86% to 97% depending on the interpretation criteria that were used.…”

Section: Commentsupporting

confidence: 68%

“…The specificity of MRI that has been reported in the literature varies widely (range, 30%-83%). 5,6,8,10,14,15,26 Our results indicate that the specificity of MRI is only moderate (67.4%). To improve The area under the receiver operating characteristic curve is 0.90 (95% confidence interval [CI], 0.83-0.96) for mostly fat; 0.91 (95% CI, 0.87-0.95) for scattered fibroglandular tissue; 0.87 (95% CI, 0.83-0.91) for heterogeneously dense; and 0.84 (95% CI, 0.74-0.93) for extremely dense.…”

Section: Commentmentioning

confidence: 67%

“…80%. 5,6,8,10,14,15 Interpretation of MRI is complicated by 2 fundamentally different methods for performing breast MRI that are currently used. These 2 methods characterize lesions as malignant based on 3-dimensional MRI to assess lesion morphology or dynamic MRI after bolus injection of gadolinium contrast to assess lesion enhancement.…”

mentioning

confidence: 99%

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Magnetic Resonance Imaging of the Breast Prior to Biopsy

Bluemke

Gatsonis

Chen

et al. 2004

JAMA

462

286

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AMMOGRAPHY IS THE PRImary imaging modality used to detect clinically occult breast cancer. However, mammography has limitations in both sensitivity and specificity that have led to exploration of other imaging techniques. Magnetic resonance imaging (MRI) has been evaluated for breast imaging because of its value for assessing soft tissues of the body. Breast MRI is performed before and after injection of a gadoliniumbased contrast agent. 1,2 Additional lesions seen by MRI that are not visible on the mammogram have been reported to be present in between 27% and 37% of patients. 3,4 The use of MRI to evaluate women with mammographically or clinically suspicious breast lesions who are undergoing biopsy has shown high potential, with the reported sensitivities of MRI for breast cancer from larger single center studies ranging from 88% to 95%. 5-12 Thus, there has been considerable enthusiasm for breast MRI and use of the procedure for Medicare patients increased almost 3-fold between 2001 (3440 examinations) and 2003 (10 115 examinations). 13 However, the reported specificity of MRI is variable, ranging from 30% to For editorial comment see p 2779.

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Section: Commentsupporting

confidence: 68%

Section: Commentmentioning

confidence: 67%

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Magnetic Resonance Imaging of the Breast Prior to Biopsy

Bluemke

Gatsonis

Chen

et al. 2004

JAMA

462

286

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“…However, despite enthusiastic initial reports, most of these methods have so far been disappointing (7,8) except for ultrasonography (US) and magnetic resonance imaging (MRI).…”

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confidence: 98%

Differentiation between benign and malignant breast tumors using kinetic features of real-time harmonic contrast-enhanced ultrasound

et al. 2012

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Background Contrast-enhanced ultrasound (CEUS) has gained interest because of its ability to gather vascular information in diverse organs. There is still a subject of debate concerning its value in breast lesions, especially as a differential diagnostic tool. Purpose To investigate whether kinetic parameters of CEUS can differentiate between malignant and benign breast lesions. Material and Methods We evaluated 75 malignant and 21 benign lesions in the breast or axilla. Contrast harmonic imaging (CHI) US was performed after the injection of a bolus dose of 2.4 mL of Sono Vue® (Bracco, Milano, Italy). The following parameters were calculated for kinetic analysis: initial slope, time to peak enhancement, wash-out ratios W21 and W50 (relative decrease in signal intensity from the peak enhancement to 21 s and 50 s, respectively). Results A significant difference was found between the benign and malignant lesions in time-to-peak ( P value <0.05) and wash-out ratios W21 ( P value <0.001) and W50 ( P value <0.001). The mean time-to-peak was 9.3 s for malignant and 14.6 s for benign lesions. The mean signal drop from peak to signal intensity measured at 50 s was 85% for malignant and 66% for benign lesions. There was no difference in absolute values of peak signal intensity and initial slope. The most significant difference between standardized benign and malignant wash-out curves was found at 21 s but statistical significance was reached in the range of 14–50 s. Conclusion Real-time CEUS can evolve into a new non-invasive option for differentiate malignant from benign breast lesions.

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“…Several studies have compared contrast‐enhanced breast MRI and SMM for diagnostic accuracy 27,29–32 . A study from Ireland of patients with palpable breast masses (mean age 51 years), of whom 21 were found to have FNAB‐proven malignant lesions, showed respective diagnostic sensitivities of 90 and 95% for breast MRI and 99m Tc tetrofosmin SMM.…”

Section: Discussionmentioning

confidence: 99%

Complementary role of adjunctive breast magnetic resonance imaging and scintimammography in patients of all ages undergoing breast cancer surgery

Howarth

Slater

Lau

et al. 2005

Australasian Radiology

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The aims of this study were to assess breast MRI and scintimammography (SMM) for the detection of breast cancer, and to determine any complementary role of these tests to each other and conventional imaging. Seventy-two patients (age 35-81 years) with a suspicious breast mass were investigated by mammography, breast ultrasound, breast MRI and SMM before undergoing surgical excision of the breast mass. Sensitivity, specificity and area under receiver operator characteristic curves were calculated for each test. Of the 72 patients, there were 66 proven malignant tumours, including two patients with bilateral breast cancer. When comparing the diagnostic sensitivity of breast MRI and SMM for lesion size, both tests showed higher sensitivities for lesions >25 mm in size, particularly for SMM. When these tests were compared for patient age, patients less than 51 years showed higher sensitivities for both tests. This was statistically significant for breast MRI. The overall respective diagnostic sensitivities for mammography, mammography with breast ultrasound, breast MRI and SMM were 56, 67, 86 and 85%. The differences were significant between mammography, mammography/ultrasound and both breast MRI and SMM. Breast MRI and SMM offer incremental diagnostic advantage in the diagnosis of breast cancer. Although improved diagnostic accuracy is seen in patients of all ages, those patients less than 51 years of age receive the greatest diagnostic benefit.

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Comparison of 99mTc-Sestamibi Scintimammography and Dynamic MR Imaging as Adjuncts to Mammography in the Diagnosis of Breast Cancer

Abstract: If high sensitivity and spatial resolution are needed, CE-MRI is to be preferred in clinical practice as an adjunct to mammography, rather than scintigraphy.

Cited by 13 publications

References 13 publications

Magnetic Resonance Imaging of the Breast Prior to Biopsy

Magnetic Resonance Imaging of the Breast Prior to Biopsy

Differentiation between benign and malignant breast tumors using kinetic features of real-time harmonic contrast-enhanced ultrasound

Complementary role of adjunctive breast magnetic resonance imaging and scintimammography in patients of all ages undergoing breast cancer surgery

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