Abstract

BackgroundWe sought to determine the diagnostic efficacy of Breast-specific gamma imaging (BSGI) in Chinese women with BI-RADS 4 category lesions and to compare this efficacy to that of ultrasound/mammography.MethodsWe retrospectively analyzed data from 177 women that had undergone BSGI of BI-RADS 4 category lesions originally detected via ultrasound and/or mammography.ResultsOf these 177 cases, 117 (66.1%) were malignant lesions and 60 (33.9%) were benign. The sensitivity, specificity, positive predictive values, and negative predictive values of BSGI were 94.9% (111/117), 78.3% (47/60), 89.5% (111/124), and 88.7% (47/53), respectively. The specificity and positive predictive values for mammography were 48.3% (29/60) and 77.5% (107/138), while for ultrasound they were 53.3% (32/60) and 79.6% (109/137), respectively. The sensitivity and specificity of BSGI for the detection of lesions ≤1 cm in size were 90.9% (10/11) and 88.0% (22/25), respectively, while for breast lesions >1 cm in size these values were 94.3% (100/106) and 71.4% (25/35), respectively. In addition, BSGI sensitivity and specificity values for dense breast tissue were 94.0% (79/84) and 78.0% (39/50), respectively, whereas for non-dense breast tissue these vales were 97.0% (32/33) and 80.0% (8/10), respectively. The sensitivity of BSGI for invasive ductal carcinomas (IDC) and ductal carcinomas in situ (DCIS) was 98.9% (95/96) and 75.0% (9/12), respectively. The tumor to normal tissue ratio of BSGI for malignant lesions was significantly higher than for benign lesions (2.18 ± 1.17 vs 1.66 ± 0.40, t = 7.56, P<0.05).ConclusionsThese results indicate that BSGI is highly sensitive for the detection of such lesions, achieving good positive/negative predictive values. This suggests that for IDC in particular, BSGI is superior to ultrasound and mammography for the diagnosis of BI-RADS 4 category lesions, although this was less apparent for the diagnosis of DCIS lesions. BSGI exhibited excellent performance in dense breast tissue and for the detection of lesions ≤1 cm in size.

Highlights

  • We sought to determine the diagnostic efficacy of Breast-specific gamma imaging (BSGI) in Chinese women with BreastImaging Reporting and Data System (BI-RADS) 4 category lesions and to compare this efficacy to that of ultrasound/mammography

  • Imaging Reporting and Data System (BI-RADS) 4 category lesions detected via ultrasound and/or mammography in order to resolve the best approach to accurately diagnosing these lesions

  • We evaluated the diagnostic efficacy of BSGI for the differential diagnosis of BIRADS 4 lesions identified via ultrasound/mammography and we compared these three approaches in order to evaluate their relative diagnostic utility

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Summary

Introduction

We sought to determine the diagnostic efficacy of Breast-specific gamma imaging (BSGI) in Chinese women with BI-RADS 4 category lesions and to compare this efficacy to that of ultrasound/mammography. Imaging Reporting and Data System (BI-RADS) 4 category lesions detected via ultrasound and/or mammography in order to resolve the best approach to accurately diagnosing these lesions. The BI-RADS 4 classification is intended to designate potentially suspicious masses warranting biopsy, with 3 subtypes (4a, 4b, and 4c) of increasing suspicion. These lesions, by definition, do not exhibit the morphological characteristics of breast cancer. They have a risk of malignancy that can range from 2 to 95% over

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