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Scintimammography with Dedicated Breast Camera Detects and Localizes Occult Carcinoma

Leonard R. Coover, MD1, Gina Caravaglia, DO2 and Phyllis Kuhn, PhD3

1 Department of Nuclear Medicine, Hamot Medical Center, Erie, Pennsylvania
2 Loyola University, Chicago, Illinois
3 Lake Erie Research Institute, Erie, Pennsylvania



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  		FIGURE 1. Dedicated breast camera attached to an adapter that allows the unit to be mounted on most mammography units.

 


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  		FIGURE 2. The extrinsic resolution (Resolution) vs. source depth for a standard {gamma}-camera (STD Gamma Cam) with 3.5-mm intrinsic resolution and a dedicated breast camera (LumaGEM) with 2-mm intrinsic resolution. The solid line represents extrinsic resolution vs. source depth when detector resolution is equal to collimator resolution (Coll Res = Det). The points representing the standard {gamma}-camera ({circ}) and the dedicated breast camera ({triangleup}) are shown.

 


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  		FIGURE 3. Image acquisition using the dedicated breast camera in caudal (left) and lateral oblique (right) projections, with the detector on the undersurface and the inferolateral surface, respectively, of the breast.

 


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  		FIGURE 4. Localization needles placed using the dedicated breast camera.

 


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  		FIGURE 5. Dedicated breast camera image of the biopsy specimen confirms that the localized lesion (infiltrating lobular carcinoma) was contained within the specimen.

 


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  		FIGURE 6. Patient 1, with infiltrating lobular carcinoma. Mediolateral oblique mammogram failed to demonstrate a nonpalpable lesion that was obscured by dense fibroglandular tissue. The circled, loosely grouped calcifications were anterior to the tumor and had been stable for years. The lesion was interpreted as BI-RADS category 2.

 


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  		FIGURE 7. Lateral scintimammograms of patient 1 obtained with a conventional {gamma}-camera. The images were acquired with the patient supine and with the breast dependent. These images were interpreted as showing normal findings. An anterior view of the chest showed a focal area of increased uptake, which would be interpreted as a positive finding of indeterminate location.

 


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  		FIGURE 8. Scintimammograms of patient 1 obtained with a dedicated breast camera. Better signal-to-noise ratio allowed lesion detection. These images were interpreted as showing positive findings. Biopsy revealed infiltrating lobular carcinoma.

 


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  		FIGURE 9. Biopsy results for dedicated breast camera vs. standard {gamma}-camera.

 




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