| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Department of Radiology, Harbor UCLA Medical Center, Torrance, California; Department of Radiology, The University of Texas Medical Branch at Galveston, Galveston, Texas; Women's Imaging Center of Delaware, Newark, Delaware; Departments of Pathology, Radiology, and Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and DuPont Pharmaceuticals Company, Wilmington, Delaware, and North Billerica, Massachusetts
Although mammography is well established as a first-line tool for breast cancer screening and detection, efforts to develop complementary procedures continue. Observation of 99mTc-sestamibi tumor uptake provided the impetus for its evaluation as an adjunctive technique. This trial's objectives were to determine in a multicenter trial the diagnostic accuracy of 99mTc-sestamibi in women with suspected breast cancer and to investigate factors influencing diagnostic accuracy. Methods: Our multicenter trial enrolled 673 women (387 with nonpalpable abnormalities; 286 with palpable abnormalities) scheduled for excisional biopsy or mastectomy. Blinded and unblinded interpretations of scintigraphic images were compared with core laboratory established histopathologic diagnoses to define the diagnostic accuracy of 99mTc-sestamibi breast imaging. Results: Blinded readers' diagnostic accuracy was 78%–81%. Inter-reader agreement was excellent, ranging from 95% to 100% (
= 0.82–0.99). Overall institutional sensitivity and specificity for 99mTc-sestamibi breast imaging were 75.4% and 82.7%, respectively. In this population with a 40.1% disease prevalence, the positive predictive value was 74.5% and the negative predictive value was 83.4%. The negative predictive value was 94% in patients with a 40% or lower mammographic likelihood of breast cancer. Sensitivity was higher for palpable abnormalities; specificity was higher for nonpalpable abnormalities. Sensitivity was decreased for tumors <1 cm in largest dimension but appeared not to be affected by patient's age. Conclusion: As an adjunct to current procedures, 99mTc-sestamibi breast imaging may contribute to patient management decisions in selected populations, including women with dense breasts, mammographically indeterminate lesions >1 cm, and palpable abnormalities.
Key Words: scintimammography • 99mTc-sestamibi • breast cancer • breast
Received Nov. 29, 1999; revision accepted May 16, 2000.
For correspondence or reprints contact: Stephen B. Haber, PhD, DuPont Pharmaceuticals Company, 331 Treble Cove Rd., 500-2, North Billerica, MA 01862.
This article has been cited by other articles:
|
|
 |
|
  T. Bach-Gansmo, R. Danielsson, A. Saracco, B. Wilczek, T. V. Bogsrud, A. Fangberget, A. Tangerud, and D. Tobin Integrin Receptor Imaging of Breast Cancer: A Proof-of-Concept Study to Evaluate 99mTc-NC100692 J. Nucl. Med., September 1, 2006; 47(9): 1434 - 1439. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Mathieu, S. Mazy, B. Willemart, M. Destine, G. Mazy, and M. Lonneux Inconclusive Triple Diagnosis in Breast Cancer Imaging: Is There a Place for Scintimammography? J. Nucl. Med., October 1, 2005; 46(10): 1574 - 1581. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Brem, J. A. Rapelyea, G. Zisman, K. Mohtashemi, J. Raub, C. B. Teal, S. Majewski, and B. L. Welch Occult Breast Cancer: Scintimammography with High-Resolution Breast-specific Gamma Camera in Women at High Risk for Breast Cancer Radiology, October 1, 2005; 237(1): 274 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Tiling, K. Stephan, H. Sommer, N. Shabani, R. Linke, and K. Hahn Tissue-Specific Effects on Uptake of 99mTc-Sestamibi by Breast Lesions: A Targeted Analysis of False Scintigraphic Diagnoses J. Nucl. Med., November 1, 2004; 45(11): 1822 - 1828. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Mankoff, L. K. Dunnwald, and P. Kinahan Are We Ready for Dedicated Breast Imaging Approaches? J. Nucl. Med., April 1, 2003; 44(4): 594 - 595. [Full Text] [PDF]
|
|
|
|
|
|
B. Mueller, M. K. O'Connor, I. Blevis, D. J. Rhodes, R. Smith, D. A. Collins, and S. W. Phillips Evaluation of a Small Cadmium Zinc Telluride Detector for Scintimammography J. Nucl. Med., April 1, 2003; 44(4): 602 - 609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Massardo, O. Alonso, L. Kabasakal, A. Llamas-Olier, U. R. Shankar, H. Zhu, L. Delgado, P. Gonzalez, F. Mut, and A. K. Padhy Diagnostic Value of 99mTc-Methylene Diphosphonate and 99mTc-Pentavalent DMSA Compared with 99mTc-Sestamibi for Palpable Breast Lesions J. Nucl. Med., July 1, 2002; 43(7): 882 - 888. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Lastoria, S. Piccolo, and P. Muto Invited Commentary: One Step Forward J. Nucl. Med., July 1, 2002; 43(7): 916 - 917. [Full Text] [PDF]
|
|
|
|
|
|
R. Sciuto, R. Pasqualoni, S. Bergomi, G. Petrilli, P. Vici, F. Belli, C. Botti, M. Mottolese, and C. L. Maini Prognostic Value of 99mTc-Sestamibi Washout in Predicting Response of Locally Advanced Breast Cancer to Neoadjuvant Chemotherapy J. Nucl. Med., June 1, 2002; 43(6): 745 - 751. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. L. McKnight, J. L. Kugel, P. J. Rossman, A. Manduca, L. C. Hartmann, and R. L. Ehman MR Elastography of Breast Cancer: Preliminary Results Am. J. Roentgenol., June 1, 2002; 178(6): 1411 - 1417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Palmedo What Can We Expect from MDR Breast Cancer Imaging with Sestamibi? J. Nucl. Med., April 1, 2002; 43(4): 526 - 530. [Full Text] [PDF]
|
|
|
|
|
|
P. Shaffer, I. Khalkhali, and S. B. Haber Sestamibi Scanning of Breast Cancer J. Nucl. Med., January 1, 2002; 43(1): 125 - 126. [Full Text] [PDF]
|
|
|
|
|
|
I. Khalkhali, J. K. Baum, J. Villanueva-Meyer, S. L. Edell, L. G. Hanelin, C. E. Lugo, R. Taillefer, L. M. Freeman, C. E. Neal, A. M. Scheff, et al. 99mTc Sestamibi Breast Imaging for the Examination of Patients with Dense and Fatty Breasts: Multicenter Study Radiology, January 1, 2002; 222(1): 149 - 155. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Alonso, T. Massardo, L. B. Delgado, J. Horvath, L. Kabasakal, A. Llamas-Olier, K. K. Maunda, R. Morales, A. K. Padhy, and U. R. Shankar Is 99mTc-Sestamibi Scintimammography Complementary to Conventional Mammography for Detecting Breast Cancer in Patients with Palpable Masses? J. Nucl. Med., November 1, 2001; 42(11): 1614 - 1621. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J R Buscombe Scintimammography Imaging, September 1, 2001; 13(3): 164 - 170. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. V. Kotlyarov and R. L. Polan Invited Commentary Author's Response RadioGraphics, May 1, 2001; 21(3): 653 - 654. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
