Brem Rachel F, Ioffe Marina, Rapelyea Jocelyn A, Yost Kristen G, Weigert Jean M, Bertrand Margaret L, Stern Lillian H
Department of Radiology, Breast Imaging and Interventional Center, George Washington University Medical Center, NW, Washington, DC 20037, USA.
AJR Am J Roentgenol. 2009 Feb;192(2):379-83. doi: 10.2214/AJR.07.3827.
The objective of our study was to compare the sensitivity of mammography, sonography, MRI, and breast-specific gamma imaging (BSGI) in the detection of invasive lobular carcinoma.
This is a retrospective multicenter study of women with biopsy-proven invasive lobular carcinoma. All patients had undergone mammography and BSGI, and the imaging findings were classified as positive or negative for invasive lobular carcinoma by experienced breast imagers. The results of MRI and sonography, if either was performed, were included. Final surgical pathology results were used as the reference standard and the lesion sensitivities of BSGI, mammography, sonography, and MRI were then statistically compared using CIs.
Twenty-six women ranging in age from 46 to 82 years (mean age, 62.8 years) with a total of 28 biopsy-proven invasive lobular carcinomas were included in the study group. Mammograms were negative in six of 28 (21%), yielding a sensitivity of 79%. In the 25 patients who underwent sonography, 17 had focal hypoechoic areas, yielding a sensitivity of 68%. In the 12 patients who underwent MRI, the sensitivity was 83%. BSGI had a sensitivity of 93%. There was no statistically significant difference in the sensitivity of BSGI, MRI, sonography, or mammography, although there was a nonsignificant trend toward improved detection with BSGI.
BSGI has the highest sensitivity for the detection of invasive lobular carcinoma with a sensitivity of 93%, whereas mammography, sonography, and MRI showed sensitivities of 79%, 68%, and 83%, respectively. BSGI is an effective technique that should be used to evaluate patients with suspected cancer and has a promising role in the diagnosis of invasive lobular carcinoma.
我们研究的目的是比较乳腺钼靶、超声、磁共振成像（MRI）和乳腺特异性γ成像（BSGI）在检测浸润性小叶癌方面的敏感性。
这是一项对经活检证实为浸润性小叶癌的女性患者进行的回顾性多中心研究。所有患者均接受了乳腺钼靶和BSGI检查，影像结果由经验丰富的乳腺影像诊断医师判定为浸润性小叶癌阳性或阴性。若患者进行了MRI或超声检查，其结果也纳入研究。最终手术病理结果用作参考标准，然后使用可信区间对BSGI、乳腺钼靶、超声和MRI的病变敏感性进行统计学比较。
研究组纳入了26名年龄在46至82岁（平均年龄62.8岁）的女性，共有28个经活检证实的浸润性小叶癌。28例中有6例（21%）乳腺钼靶检查结果为阴性，敏感性为79%。在接受超声检查的25例患者中，17例有局灶性低回声区，敏感性为68%。在接受MRI检查的12例患者中，敏感性为83%。BSGI的敏感性为93%。尽管BSGI在检测方面有不显著的改善趋势，但BSGI、MRI、超声或乳腺钼靶的敏感性在统计学上无显著差异。
BSGI检测浸润性小叶癌的敏感性最高，为93%，而乳腺钼靶、超声和MRI的敏感性分别为79%、68%和83%。BSGI是一种有效的技术，应用于评估疑似癌症患者，在浸润性小叶癌的诊断中具有广阔前景。
