title: Detection and prediction of breast cancer using double phase Tc-99m MIBI scintimammography in comparison with MRI.
abstract: BACKGROUND
  The aim of this study was to investigate the incremental diagnostic value of quantified indices of scintimammography (SMM) additive to magnetic resonance imaging (MRI) for detection of breast cancer.
  
  
  METHODS
  Double phase SMM (early: 10 min; delayed: 3 h) was performed in 239 highly suspected breast cancer patients. SMM was analyzed by visual and quantitative methods. Receiver operating characteristic curve (ROC) analyses were performed to determine the optimal visual grade, to calculate cut-off values of quantitative indices, and to evaluate incremental value.
  
  
  RESULTS
  Sensitivity and specificity of visual analysis of SMM (V) were 86.4 and 100%, respectively. ROC analysis revealed 96.1% sensitivity and 58.8% specificity of contrast-enhanced MRI. The optimal lesion to non-lesion (L/N) ratios were 1.84 for early and 1.04 for delayed. When early L/N 1.84 was used as cut-off, sensitivity and specificity of SMM were 67.8 and 97.1%, respectively. When delayed L/N 1.04 was used, sensitivity and specificity were 88.3 and 55.9%, respectively. Among the various variables of double phase SMM and MRI, early L/N was the potent predictor for breast cancer.
  
  
  CONCLUSIONS
  MRI and visual analysis early L/N showed similar diagnostic accuracy for breast cancer in the current study. Early L/N is a potential predictor for breast cancer. Further studies are needed to confirm these results and improve statistical accuracy.
authors.affiliation: Department of Nuclear Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: In Joo
authors.initials: IJ
authors.lastname: Kim
authors.forename: Yong-Ki
authors.initials: YK
authors.lastname: Kim
authors.forename: Seong-Jang
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi