Brem Rachel F, Schoonjans Joelle M, Kieper Douglas A, Majewski Stan, Goodman Steven, Civelek Cahid
Breast Imaging and Intervention Center, George Washington University Medical Center, Washington, DC 20037, USA.
J Nucl Med. 2002 Jul;43(7):909-15.
This study evaluated a novel high-resolution breast-specific gamma camera (HRBGC) for the detection of suggestive breast lesions.
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.
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 < or = 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.
Evaluation of indeterminate breast lesions with an HRBGC results in improved sensitivity for the detection of cancer, with greater improvement shown for nonpalpable and < or =1-cm lesions.
本研究评估了一种新型高分辨率乳腺专用伽马相机(HRBGC)用于检测可疑乳腺病变。
对50例(共58个乳腺病变)临床指示需进行乳腺闪烁造影的患者,前瞻性地使用通用伽马相机和新型HRBGC原型进行评估。两位不知乳腺X线摄影和组织学结果的放射科医生将传统和高分辨率核研究结果前瞻性地分类为阴性(正常或良性)或阳性(可疑或恶性)。所有纳入病变均经病理证实。
有30个良性病变和28个恶性病变。传统相机检测乳腺癌的敏感性为64.3%(18/28),HRBGC为78.6%(22/28)。两种系统的特异性均为93.3%(28/30)。对于18个不可触及的病变,通用相机和HRBGC的敏感性分别为55.5%(10/18)和72.2%(13/18)。对于直径≤1 cm的病变,通用相机检测出15个中的7个,HRBGC检测出15个中的10个。4个病变(中位大小8.5 mm)仅被HRBGC检测到,而传统相机漏检。
使用HRBGC评估不确定的乳腺病变可提高癌症检测的敏感性,对不可触及和直径≤1 cm的病变改善更大。