title: Limited value of scintimammography and contrast-enhanced MRI in the evaluation of microcalcification detected by mammography.
abstract: The aim of this study was to evaluate whether scintimammography using 99Tc(m)-sestamibi or contrast-enhanced magnetic resonance imaging (MRI) can improve the specificity of mammography for the differentiation of benign and malignant breast microcalcification. From 156 consecutive patients studied with SMM, 44 patients with microcalcification on mammograms were selected for this study. Forty patients in this group also had contrast-enhanced MRI of the breast. The intensity and patterns of sestamibi uptake for scintimammography and contrast enhancement for MRI were visually determined and graded on a 5-point scale for malignancy. The results of both techniques were compared and correlated with final histopathologic diagnoses. The sensitivity and specificity of scintimammography were 63% and 85% respectively, if only those cases classified as probable or definite malignancy were considered positive. If indeterminate findings were also considered positive, the sensitivity and specificity of scintimammography were 79% and 80% respectively. Using the latter classification for MRI revealed a comparable sensitivity of 82% but a markedly lower specificity of 56%. Excluding indeterminate findings from the group of positive MRI diagnoses resulted in a specificity of 94% and a sensitivity of 64%. In conclusion, scintimammography of the breast had a comparable sensitivity but a higher specificity than MRI. The sensitivity of both techniques, however, is probably too low for routine use in the evaluation of microcalcification detected by mammography.
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-Universität, Klinikum Innenstadt, 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: Linke
authors.forename: R
authors.initials: R
authors.lastname: Moser
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: D000328:Adult; D000368:Aged; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001941:Breast Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D002114:Calcinosis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005348:Fibrocystic Breast Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi