title: Role of technetium-99m sestamibi scintimammography and contrast-enhanced magnetic resonance imaging for the evaluation of indeterminate mammograms.
abstract: This study evaluated and compared technetium-99m sestamibi scintimammography (SMM) and breast magnetic resonance imaging (MRI) results in patients with indeterminate mammograms to determine whether either technique can improve the sensitivity and specificity for the diagnosis of breast carcinoma. From 123 consecutive patients who underwent physical examination, mammography, SMM, and histopathologic confirmation, a subgroup of 82 patients presenting with indeterminate mammograms was studied. Sixty-eight patients underwent contrast-enhanced MRI. SMM results were scored on the basis of the intensity and pattern of sestamibi uptake. MRI images were scored on the basis of signal intensity increase after administration of contrast material as well as the enhancement pattern and speed of gadolinium uptake. The results obtained with the two techniques were compared and related to the final histopathologic diagnoses. Considering indeterminate findings as positive, the sensitivity of SMM was 79% and the specificity, 70%. MRI displayed a sensitivity of 84% and a specificity of 49%. When indeterminate results were considered negative, the sensitivity and specificity of SMM were 62% and 83%, respectively. MRI revealed a sensitivity and specificity of 56% and 79%, respectively. The calculated sensitivities and specificities demonstrate the diagnostic limitations of both SMM and MRI in the evaluation of patients with indeterminate mammographic findings. Due to the higher specificity, SMM may be the preferred modality in the evaluation of selected patients with breast abnormalities.
authors.affiliation: Department of Nuclear Medicine, Klinikum Innenstadt, Ludwig-Maximilians- University of Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Tiling
authors.forename: I
authors.initials: I
authors.lastname: Khalkhali
authors.forename: H
authors.initials: H
authors.lastname: Sommer
authors.forename: R
authors.initials: R
authors.lastname: Moser
authors.forename: G
authors.initials: G
authors.lastname: Meyer
authors.forename: F
authors.initials: F
authors.lastname: Willemsen
authors.forename: T
authors.initials: T
authors.lastname: Pfluger
authors.forename: K
authors.initials: K
authors.lastname: Tatsch
authors.forename: K
authors.initials: K
authors.lastname: Hahn
mesh_terms: D001941:Breast Diseases / Q000175:diagnosis / Q000453:epidemiology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D019786:Gadolinium DTPA