title: Diagnostic performances of double-phase tc-99m MIBI scintimammography in patients with indeterminate ultrasound findings: visual and quantitative analyses.
abstract: The aim of the study was to compare the diagnostic performances of visual and quantitative analyses of double-phase Tc-99m methoxyisobutylisonitrile (MIBI) scintimammography (SMM) in patients with ultrasonographically indeterminate findings. SMM (early: 10min; delayed: 3h) was performed on 78 patients (malignant 66, benign 12). For visual analysis, the five-scoring method was used. For quantitative analysis, ratios of early and delayed lesions to non-lesion (L/Ns) were calculated. When a visual grade of over 3 was used as the cut-off value for the detection of primary breast cancer, the sensitivity and specificity were 86.4%/ and 100%, respectively. The area under the curve (AUC) was 0.972. The optimal L/N ratios were 1.22 for early and 1.1 for delayed images. When early L/N 1.22 was used as the cut-off point, the sensitivity and specificity of SMM were 92.4% and 91.7'%, respectively. The AUC was 0.952. When delayed L/N 1.1 was used as the cut-off value, the sensitivity and specificity were 78.8% and 91.7%, respectively. The AUC was 0.863. Visual interpretation and early L/N were superior to delayed L/N for the detection of breast cancer. This study suggests the possible diagnostic role of visual and quantitative analyses of double-phase SMM for differentiating malignant breast lesions in patients with ultrasonographi-cally indeterminate findings.
authors.affiliation: Department of Nuclear Medicine, College of Medicine, Pusan National University, 1-10, Ami-dong, Seo-gu, Busan 602-739, South Korea. growthkim@daum.net
authors.forename: Seong-Jang
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Bae
authors.forename: Jung S
authors.initials: JS
authors.lastname: Lee
authors.forename: In-Ju
authors.initials: IJ
authors.lastname: Kim
authors.forename: Yong-Ki
authors.initials: YK
authors.lastname: Kim
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D016217:Ultrasonography, Mammary
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi