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Overall sensitivity for whole-body and PET/CT was 96% and 93% respectively, while specificity was 87% and 88% respectively.
Conclusions
The study showed that both methods are relevant for detecting metastases in breast cancer patients, but also showed that the method chosen should be appropriate to the type of tumor which may be suspected based upon the laboratory and clinical findings. While the study found that both 1.5- and 3-tesla MRI scanning were feasible for the purpose of finding metastases, the team discovered that there is still much work to be done on refining the methods used for 3-tesla scanning. This could lead to further improvements in the results yielded by this method.
Breast gamma imaging spots DCIS better than mammo, MR
Introduction
Breast-specific gamma imaging (BSGI) is a functional study which is unaffected by dense tissue, implants or architectural distortion in the breast. The aim of the study was to assess the effectiveness of this method in detecting ductal carcinoma in situ (DCIS) in comparison to mammography and MRI methods (Pal, 2007).
Methods
22 women were selected for the study based on the presence of DCIS which had been confirmed through biopsy. The study did not take into account family history, genetic predisposition or breast density. BGSI was conducted both before biopsy, to assess indeterminate findings, and after biopsy, to determine foci and extent of disease. BGSI was conducted after injection of 25-30 mCi of technetium 99m-sestamibi, and results were measured by radio-tracer uptake on a five point scale, with 1 being normal, and 5 being abnormal, with marked focal...
Mammography was performed in craniocaudal and mediolateral positions, and gadolinium enhanced MRI was performed with a 1.5-tesla scanner.
Results
Mammography obtained a sensitivity of 82%, detecting 18 of the 22 cases, in comparison to BGSI, which produced a sensitivity of 91%. Only seven of the women had MR exams, which produced a sensitivity of 88%, with one false-negative, which was discovered to be positive by BGSI. The BGSI was found to have especially high sensitivity for small lesions, detecting 100% of DCIS of 10mm or smaller.
Conclusions
The results of the study show what they set out to achieve, which is that BGSI is at least as effective, if not more so than mammography or MRI imaging for DCIS. The high sensitivity of BGSI for small DCIS makes the results of the study particularly important, along with the case in which BGSI correctly identified DCIS when a false-negative was produced by MRI. Overall the study has shown that mammography is not an entirely accurate method of detection for DCIS, with MRI giving better results, but DCIS giving better results still, which may be crucial in decisions regarding testing methods used in the future.
References
Jeong-Sik Yu et al. (2007) Fat containing nodules in the cirrhotic liver: Chemical shift MRI features and clinical implications. AJR, 188: 1009-1016.
Pal, S. (2007) Breast gamma imaging spots DCIS better than mammo, MR. Retrieved September 5, 2007, at http://AuntMinnie.com.
Tilke, B. (2007) PET/CT, whole-body MRI each have merits in metastatic breast disease. Retrieved September 5, 2007, at http://AuntMinnie.com.
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