title: Fusion of magnetic resonance and scintimammography images for breast cancer evaluation: a pilot study.
abstract: BACKGROUND
  To achieve a more specific method to estimate the real size of breast cancer, we have developed a method to fuse magnetic resonance imaging (MRI) and scintimammography (SM) images. The aim of this study was to assess the feasibility of this method and to evaluate its accuracy to measure the size of breast cancer compared with MRI alone, mammography, and clinical examination, employing pathologic size as the gold standard.
  
  
  METHODS
  Twenty consecutive breast cancer women at stages IIA-IIIA, scheduled for mastectomies, underwent SM with (99m)Tc-sestamibi and MRI with gadolinium 2-10 days before surgery. All patients had had recent mammographies and were examined clinically. Software was developed in visual language to perform the fusion between MRI and SM images and tumor measurements (MRI/SM). The tumor size, in 3 diameters (anteroposterior, longitudinal, and transverse), for each examination was correlated with pathological measurements using linear regression.
  
  
  RESULTS
  The MRI/SM technique was successfully performed in all patients, and the principal tumor was measured by this method. The MRI/SM cancer measurements correlated better with pathology than MRI, mammography, and clinical exam in all diameters analyzed (r = 0.88, 0.81, 0.81; SE = 0.11, 0.14, 0.11 in anteroposterior, longitudinal, and transverse diameters, respectively).
  
  
  CONCLUSIONS
  The MRI/SM is a feasible technique and appears to be more accurate than other examinations (MRI alone, mammography, and clinical exam) to measure breast cancer size.
authors.affiliation: Division of Oncology and Senology, Department of Obstetrics and Gynecology School of Medicine, Universidade Estadual de Campinas (Unicamp), Campinas, Brazil. giuliano.duarte@ig.com.br
authors.forename: Giuliano Mendes
authors.initials: GM
authors.lastname: Duarte
authors.forename: César
authors.initials: C
authors.lastname: Cabello
authors.forename: Renato Zocchio
authors.initials: RZ
authors.lastname: Torresan
authors.forename: Marcelo
authors.initials: M
authors.lastname: Alvarenga
authors.forename: Gilliat H Q
authors.initials: GH
authors.lastname: Telles
authors.forename: Susana Trigo
authors.initials: ST
authors.lastname: Bianchessi
authors.forename: Nelson
authors.initials: N
authors.lastname: Caserta
authors.forename: Silmara R
authors.initials: SR
authors.lastname: Segala
authors.forename: Mariana da Cunha Lopes
authors.initials: Mda C
authors.lastname: de Lima
authors.forename: Elba Cristina Sá de Camargo
authors.initials: EC
authors.lastname: Etchebehere
authors.forename: Edwaldo E
authors.initials: EE
authors.lastname: Camargo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tinois
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D011877:Radionuclide Imaging / Q000379:methods*; D012680:Sensitivity and Specificity; D012984:Software; D017256:Technetium Tc 99m Sestamibi
chemical_list: D017256:Technetium Tc 99m Sestamibi