Breast-specific gamma imaging compared to ultrasound in the management of patients with BIRADS 0 mammograms

Objectives To compare the impact of BSGI and ultrasound on patient management in patients who have a BIRADS 0 mammogram and a remaining diagnostic concern.

Methods A patient registry was maintained on patients routinely scheduled for a BSGI examination due to clinical or radiologic findings. All imaging studies were conducted as deemed clinically necessary and all patient history was available at the time of interpretation. Biopsy was conducted as deemed clinically necessary and used as the gold standard. Pathology results were classified as positive (malignancy present); high-risk (a pathology associated with a risk of malignancy, requiring lumpectomy) and negative (no malignant or high-risk pathologies present). Imaging studies were classified as negative - no biopsy indicated; Positive - Biopsy indicated or No change in management - BIRADS 0.

Results There were 119 patients with 102 benign, 15 malignant, and 2 high-risk lesions. Ultrasound resulted in no change in management for 48 patients (44 benign, 3 malignant and 1 high-risk). Ultrasound was negative in 33 cases (30 benign and 3 malignant) It was positive in 38 cases (28 benign, 9 malignant and 1 high-risk). BSGI resulted in no change in management in 10 cases, all benign. 34 patients had positive BSGI studies (17 benign, 15 malignant and 2 high-risk lesions) and 75 negative studies, all benign.

Conclusions BSGI was significantly more likely to contribute to patient management than ultrasound (109 vs. 71 patients) and it was less likely to be negative in malignant lesions (3 vs. 0) and less likely to be positive in benign lesions (17 vs. 30)

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BSGI compared to ultrasound in the management of patients with BIRADS 0 mammograms