Ann Surg Treat Res.  2016 Apr;90(4):194-200. 10.4174/astr.2016.90.4.194.

Validity of breast-specific gamma imaging for Breast Imaging Reporting and Data System 4 lesions on mammography and/or ultrasound

• Cho MJ
• Yang JH
• Yu YB
• Park KS
• Chung HW
• So Y
• Choi N
• Kim MY

• KMID: 2160948
• DOI: http://doi.org/10.4174/astr.2016.90.4.194

Abstract

PURPOSE
The purpose of this study was to assess the breast-specific gamma imaging (BSGI) in Breast Imaging Reporting and Data System (BI-RADS) 4 lesions on mammography and/or ultrasound.
METHODS
We performed a retrospective review of 162 patients who underwent BSGI in BI-RADS 4 lesions on mammography and/or ultrasound.
RESULTS
Of the 162 breast lesions, 66 were malignant tumors and 96 were benign tumors. Sensitivity and specificity of BSGI were 90.9% and 78.1%, and positive predictive value and negative predictive value were 74.1% and 92.6%. The sensitivity or specificity of mammography and ultrasound were 74.2% and 56.3% and 87.9% and 19.8%, respectively. The sensitivity and specificity of BSGI for breast lesions ≤1 cm were 88.0% and 86.8%, while the values of beast lesions >1 cm were 92.7% and 61.5%. The sensitivity or specificity of BSGI and mammography for patients with dense breasts were 92.0% and 81.3% and 72.0% and 50.0%, respectively. 26 patients showed neither a nodule nor microcalcification on ultrasound, but showed suspicious calcification on mammography. The sensitivity and specificity of BSGI with microcalcification only lesion were 75.0% and 94.4%.
CONCLUSION
This study demonstrated that BSGI had shown high sensitivity and specificity, as well as positive and negative predictive values in BI-RADS 4 lesions on ultrasound and/or mammography. BSGI showed excellent results in dense breasts, in lesions that are less than 1 cm in size and lesions with suspicious microcalcification only.

Keyword

Breast neoplasms; Breast specific gamma imaging; Mammography; Ultrasonography

MeSH Terms

Breast Neoplasms
Breast*
Humans
Information Systems*
Mammography*
Retrospective Studies
Sensitivity and Specificity
Ultrasonography*

Figure

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  Fig. 1 Breast image of a 53-year-old woman. (A, B) Mammography did not demonstrate any abnormal lesions in the heterogeneously dense breast. (C, D) Breast specific gamma imaging demonstrated focal increased radiotracer uptake in the upper outer quadrant area (arrow) of the right breast. (E) Ultrasound demonstrated an ill-defined hypoechoic nodule at 9 h of the right breast (arrow). Pathology demonstrated an 8-mm focus of invasive ductal carcinoma.

• 

  Fig. 2 A 47-year-old woman with left breast microcalcifications. (A–C) Mammography (left craniocaudal, left mediolateral oblique, left mediolateral oblique magnification) demonstrated cluster of amorphous microcalcifications at the upper out quadrant area. (D, E) Breast specific gamma imaging demonstrated focal increased radiotracer uptake in the upper outer quadrant area (arrow) of the left breast. (F) Ultrasound was negative and is not shown. Pathology demonstrated a 9-mm focus of lobular carcinoma in situ.

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  Fig. 3 A 37-year-old woman with a palpable lump in the left breast. (A, B) Mammography demonstrated a large mass at 12 h of the left breast. (C, D) Breast specific gamma imaging demonstrated increased radiotracer uptake in the upper inner quadrant area of the left breast. (E) Ultrasound demonstrated 70-mm hypoechoic mass in the left breast. Pathology demonstrated a 56-mm benign phyllodes tumor.

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