title: Scintimammography with dedicated breast camera in unifocal and multifocal/multicentric primary breast cancer detection: a comparative study with SPECT.
abstract: The aim of this study was to assess the usefulness of planar scintimammography (SM) with a high-resolution dedicated breast camera (DBC) compared to SPECT in unifocal and multifocal/multicentric primary breast cancer (BC) detection. DBC planar SM and conventional SPECT were acquired using 99mTc-tetrofosmin as radiotracer in 85 consecutive patients suspect for BC at conventional imaging and clinical examination. Scintigraphic data were related to histology in all cases. BC was proven in 74/85 patients, unifocal in 56/74 cases and multifocal/multicentric in 18/74; 90 carcinomas were ascertained. Benign lesions were found in 12 cases, including one who also had BC in the contralateral breast. DBC planar SM and SPECT were true-positive in 72/74 and in 70/74 BC patients, respectively, and globally detected 96.7% and 92.2% of carcinomas. DBC and SPECT sensitivity were, respectively, 90.3% and 80.6% in <or=10-mm carcinomas and 100% and 98.3% in larger ones; sensitivity values in non-palpable carcinomas were 92.6% and 77.8%, respectively, and 98% for both procedures in palpable ones. DBC planar SM and SPECT correctly assessed multifocality/multicentricity in 91.7% and 83.3% of cases, respectively. Sensitivity differences were not significant. Both procedures showed only a false-positive result. DBC planar SM and SPECT proved highly sensitive and specific in BC detection, representing a useful complementary tool to mammography. However, DBC planar SM showed technical advantages and better clinical performance than SPECT in both subcentrimetric carcinoma detection and multifocal/multicentric disease assessment. Thus, DBC planar SM should be preferred, but SPECT remains a useful alternative when DBC is unavailable.
authors.affiliation: Department of Nuclear Medicine, University of Sassari, 07100 Sassari, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Spanu
authors.forename: Pierina
authors.initials: P
authors.lastname: Cottu
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manca
authors.forename: Francesca
authors.initials: F
authors.lastname: Chessa
authors.forename: Daniela
authors.initials: D
authors.lastname: Sanna
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Madeddu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009943:Organophosphorus Compounds / Q000737:chemistry; D015609:Organotechnetium Compounds / Q000737:chemistry; D011877:Radionuclide Imaging / Q000379:methods*; D019275:Radiopharmaceuticals / Q000494:pharmacology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin