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Journal of Nuclear Medicine Vol. 43 No. 7 909-915
© 2002 by Society of Nuclear Medicine


Basic Science Investigations

High-Resolution Scintimammography: A Pilot Study

Rachel F. Brem, MD1, Joelle M. Schoonjans, MD2, Douglas A. Kieper, BS3, Stan Majewski, PhD3, Steven Goodman, MD, PhD4 and Cahid Civelek, MD2

1 Breast Imaging and Intervention Center, George Washington University Medical Center, Washington, DC
2 Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Institutions, Baltimore, Maryland
3 Thomas Jefferson National Accelerator Facility, Newport News, Virginia
4 Department of Oncology, Johns Hopkins Institutions, Baltimore, Maryland

This study evaluated a novel high-resolution breast-specific gamma camera (HRBGC) for the detection of suggestive breast lesions. Methods: Fifty patients (with 58 breast lesions) for whom a scintimammogram was clinically indicated were prospectively evaluated with a general-purpose gamma camera and a novel HRBGC prototype. The results of conventional and high-resolution nuclear studies were prospectively classified as negative (normal or benign) or positive (suggestive or malignant) by 2 radiologists who were unaware of the mammographic and histologic results. All of the included lesions were confirmed by pathology. Results: There were 30 benign and 28 malignant lesions. The sensitivity for detection of breast cancer was 64.3% (18/28) with the conventional camera and 78.6% (22/28) with the HRBGC. The specificity with both systems was 93.3% (28/30). For the 18 nonpalpable lesions, sensitivity was 55.5% (10/18) and 72.2% (13/18) with the general-purpose camera and the HRBGC, respectively. For lesions <= 1 cm, 7 of 15 were detected with the general-purpose camera and 10 of 15 with the HRBGC. Four lesions (median size, 8.5 mm) were detected only with the HRBGC and were missed by the conventional camera. Conclusion: Evaluation of indeterminate breast lesions with an HRBGC results in improved sensitivity for the detection of cancer, with greater improvement shown for nonpalpable and <=1-cm lesions.

Key Words: scintimammography • breast neoplasm • high-resolution gamma camera




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