Middlesex Health, 28 Crescent St, Middletown, CT 06457.
Radiol Imaging Cancer. 2020 Sep 25;2(5):e190096. doi: 10.1148/rycan.2020190096. eCollection 2020 Sep.
To calculate the negative predictive value (NPV) and false-negative rate (FNR) of molecular breast imaging (MBI) performed in patients who had low-suspicion index findings on mammograms and US images.
This retrospective study included patients who had undergone MBI between January 2015 and July 2017, who had index findings on screening mammograms and/or US images, and for whom either histopathologic results or a minimum of 1-year imaging follow-up results were available. A drawn dose of 8 mCi (296 MBq) of technetium 99m sestamibi was administered to all patients for MBI. The NPV and FNR of MBI was calculated for the cohort of 381 findings among 338 women (median age, 56 years; age range, 28-89 years) included in this study.
Overall, 292 of the 381 (76.6%) MBI results were interpreted as negative. Of the 292, 27 patients underwent subsequent biopsies, results of which were negative for cancer; one patient underwent biopsy, and the result was positive for cancer; and 264 patients had true-negative findings based on follow-up imaging for a minimum of 1 year. Of the 89 MBI acquisitions interpreted as positive, there were 36 cancers. The NPV was calculated to be 99.7% (291 of 292, 95% confidence interval [CI]: 99.1%, 100%), and the FNR was 2.7% (one of 37, 95% CI: 0%, 7.9%). Interposing MBI reduced the number of biopsies by 67.5%.
The concept of the clinical utility of a negative MBI result may be valid but requires further testing. Breast, Molecular Imaging-Cancer© RSNA, 2020.
计算在乳腺 X 线摄影和超声图像上具有低可疑指数发现的患者中进行分子乳腺成像（MBI）的阴性预测值（NPV）和假阴性率（FNR）。
本回顾性研究纳入了 2015 年 1 月至 2017 年 7 月间接受 MBI 检查的患者，这些患者在乳腺 X 线摄影和/或超声图像上有可疑发现，且其组织病理学结果或至少 1 年的影像学随访结果可供分析。所有患者均接受 MBI 检查，静脉注射放射性核素 99mTc 锝美替比呋 8mCi（296MBq）。该研究共纳入 338 例女性的 381 个可疑发现，计算了 MBI 的 NPV 和 FNR。
在这组 381 个可疑发现中，共有 292 个（76.6%）MBI 结果为阴性。在这 292 个结果中，27 例患者接受了后续活检，结果均为阴性；1 例患者接受了活检，结果为阳性；264 例患者在进行了至少 1 年的后续影像学检查后，被证实为阴性。在 89 个 MBI 阳性结果中，有 36 个为癌症。NPV 计算为 99.7%（291/292，95%置信区间：99.1%，100%），FNR 为 2.7%（37 个中的 1 个，95%置信区间：0%，7.9%）。在该研究中，插入 MBI 减少了 67.5%的活检数量。
MBI 阴性结果具有临床应用价值的概念可能是合理的，但需要进一步的验证。乳腺，分子成像-癌症©RSNA，2020。
