title: Clinical usefulness of breast-specific gamma imaging as an adjunct modality to mammography for diagnosis of breast cancer: a systemic review and meta-analysis.
abstract: OBJECTIVE
  The purpose of this study was to assess the diagnostic performance of breast-specific gamma imaging (BSGI) as an adjunct modality to mammography for detecting breast cancer.
  
  
  METHODS
  Comprehensive searches of MEDLINE (1984 to August 2012) and EMBASE (1994 to August 2012) were performed. A summary receiver operating characteristic curve (SROC) was constructed to summarize the overall test performance of BSGI. The sensitivities for detecting subcentimetre cancer and ductal carcinoma in situ (DCIS) were pooled. The potential of BSGI to complement mammography was also evaluated by identifying mammography-occult breast cancer.
  
  
  RESULTS
  Analysis of the studies revealed that the overall validity estimates of BSGI in detecting breast cancer were as follows: sensitivity 95 % (95 % CI 93-96 %), specificity 80 % (95 % CI 78-82 %), positive likelihood ratio 4.63 (95 % CI 3.13-6.85), negative likelihood ratio 0.08 (95 % CI 0.05-0.14), and diagnostic odds ratio 56.67 (95 % CI 26.68-120.34). The area under the SROC was 0.9552 and the Q* point was 0.8977. The pooled sensitivities for detecting subcentimetre cancer and DCIS were 84 % (95 % CI 80-88 %) and 88 % (95 % CI 81-92 %), respectively. Among patients with normal mammography, 4 % were diagnosed with breast cancer by BSGI, and among those with mammography suggestive of malignancy or new biopsy-proven breast cancer, 6 % were diagnosed with additional cancers in the breast by BSGI.
  
  
  CONCLUSIONS
  BSGI had a high diagnostic performance as an excellent adjunct modality to mammography for detecting breast cancer. The ability to identify subcentimetre cancer and DCIS was also high.
authors.affiliation: Department of Breast Surgery of Guangxi Cancer Hospital, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Hua-Wei
authors.initials: HW
authors.lastname: Yang
authors.forename: Jian-Lun
authors.initials: JL
authors.lastname: Liu
mesh_terms: D000818:Animals; D001940:Breast / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008327:Mammography / Q000379:methods*; D009928:Organ Specificity; D011877:Radionuclide Imaging / Q000379:methods*