Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
J Womens Health (Larchmt). 2012 Jul;21(7):730-8. doi: 10.1089/jwh.2011.3267. Epub 2012 Mar 9.
Our objective was to explore the potential benefits of molecular breast imaging (MBI) as a screening technique in women undergoing stress myocardial perfusion studies.
MBI was offered to women receiving Tc-99m sestamibi injection for myocardial perfusion stress testing. During the required waiting period after stress isotope injection, MBI was performed using a dedicated breast imaging gamma camera system. MBI examinations were interpreted by breast radiologists, with review of a recent mammogram in cases with positive MBI.
Of 322 women enrolled, 313 completed MBI, comprising 5 with known breast cancer, 2 with known high-risk benign breast lesions, and 306 who were asymptomatic for breast disease with a recent negative mammogram. Analysis was limited to the 306 patients with no known breast disease. MBI was positive in 22 of 306, giving a recall rate of 7.2% (95% confidence interval [CI] 4.8-10.6]. MBI detected 4 new cancers, resulting in a supplemental diagnostic yield of 13.1/1000 women screened (95% CI 5.1-33.2). The number of cancers diagnosed per abnormal MBI examinations (PPV(1)) was 18% (4 of 22) (95% CI 7.3-38.5), and the number diagnosed per MBI-prompted biopsies (PPV(3)) was 44% (4 of 9) (95% CI 18.9-73.3).
The addition of MBI to clinically indicated stress myocardial perfusion imaging studies in women results in a high diagnostic yield of newly detected breast cancers while generating a low rate of additional unnecessary workup.
我们的目的是探讨分子乳腺成像（MBI）作为应激心肌灌注研究女性筛查技术的潜在益处。
为接受 Tc-99m sestamibi 注射进行心肌灌注应激测试的女性提供 MBI。在应激同位素注射后所需的等待期内，使用专用乳腺成像伽马相机系统进行 MBI。由乳腺放射科医生解释 MBI 检查结果，并在 MBI 阳性的情况下回顾最近的乳房 X 线照片。
在纳入的 322 名女性中，有 313 名完成了 MBI，其中 5 名患有已知乳腺癌，2 名患有已知高危良性乳腺病变，306 名无症状且最近的乳房 X 线照片为阴性。分析仅限于 306 名无已知乳房疾病的患者。MBI 在 306 名患者中有 22 例阳性，召回率为 7.2%（95%置信区间 [CI] 4.8-10.6）。MBI 检测到 4 例新癌症，导致额外诊断率为 13.1/1000 名筛查女性（95%CI 5.1-33.2）。每例异常 MBI 检查（PPV(1)）诊断的癌症数量为 18%（22 例中的 4 例）（95%CI 7.3-38.5），每例 MBI 提示活检（PPV(3)）诊断的癌症数量为 44%（9 例中的 4 例）（95%CI 18.9-73.3）。
在女性有临床指征的应激心肌灌注成像研究中添加 MBI 可提高新发现乳腺癌的诊断率，同时降低额外不必要检查的发生率。
