Comparison of 99mTc‐Sestamibi Scintimammography and Dynamic MR Imaging as Adjuncts to Mammography in the Diagnosis of Breast Cancer

• Published in: Acta radiologica (1987) 2003-01, Vol.44 (1), p.28-34
• Main Authors: Boné, B., Wiberg, M. Kristoffersen, Szabó, B. K., Szakos, A., Danielsson, R.
• Format: Article
• Language: English
• Subjects: 99m Tc‐sestamibi scintimammography; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Contrast Media; dynamic MR imaging; Female; Gynecology. Andrology. Obstetrics; Humans; Magnetic Resonance Imaging; Mammary gland diseases; Mammography; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; ROC analysis; Sensitivity and Specificity; Severity of Illness Index; Technetium Tc 99m Sestamibi; Tumors
• ISSN: 0284-1851; 1600-0455
• DOI: 10.1034/j.1600-0455.2003.00012.x

Purpose:  To compare the diagnostic accuracy of planar 99mTc‐sestamibi scintimammography with dynamic contrast‐enhanced MRI (CE‐MRI) on the basis of histopathologic results, and to determine the clinical value of these methods as adjuncts to mammography. Material and Methods:  A total of 90 consecutive women with 111 histopathologically verified breast lesions were enrolled in the study. Patients underwent scintimammography and CE‐MRI in addition to mammography. Each finding was classified on a BI‐RADS‐like five‐point rating scale describing the degree of suspicion for malignancy, and all findings were correlated with the histopathological results. Results:  The overall sensitivity/specificity/accuracy was 85%/59%/78% for mammography, 94%/47%/80% for CE‐MRI, and 82%/75%/80% for scintimammography, respectively. CE‐MRI showed higher sensitivity ( p = 0.008), but its specificity was lower than scintimammography ( p = 0.049). Using ROC analysis, significant improvement ( p = 0.034) was found between mammography and the combination of mammography + CE‐MRI, while mammography + scintigraphy showed no higher diagnostic accuracy than mammography alone. Conclusion:  If high sensitivity and spatial resolution are needed, CE‐MRI is to be preferred in clinical practice as an adjunct to mammography, rather than scintigraphy.