Visual and semi-quantitative analyses of dual-phase breast-specific gamma imaging with Tc-99m-sestamibi in detecting primary breast cancer

Breast cancer is the most common malignancy for females worldwide. This study was to evaluate the application of dual-phase breast-specific gamma imaging (BSGI) in detecting primary breast cancer. Seventy-six patients with indeterminate breast lesions that underwent dual-phase BSGI enrolled in this study. All included lesions were confirmed by pathology. BSGI was evaluated based on the visual interpretation and dual-phase semi-quantitative indices of lesion to non-lesion ratio (L/N), which were compared with pathological results. The optimal visual analysis and L/N for double-phase were calculated through receiver operating characteristic curve analysis. Among 76 patients, 92 lesions were finally confirmed by the surgery and pathology, with 54 malignant and 38 benign lesions. Both early and delayed L/N of malignant breast diseases were significantly higher than those of benign (3.18 +/- A 1.57 vs 1.53 +/- A 0.59, and 2.91 +/- A 1.91 vs 1.46 +/- A 0.54, P < 0.05). The optimal visual interpretation is over grade 3, and cut-off L/N was 2.06 and 1.77 for early and delayed imaging, respectively. Compared with visual analysis over grade 3 (77.8 and 81.6 %), optimal early L/N (81.5 and 92.1 %) or delayed L/N (79.5 and 89.5 %) alone, the sensitivity and specificity of visual combined with early-phase L/N in diagnosing primary breast cancer are higher, which were 85.2 and 92.2 %, respectively. The combination of visual and semi-quantitative analysis could improve the sensitivity and specificity of BSGI in detecting primary breast cancer. In addition, the potential value of delayed BSGI in diagnosing primary breast cancer should be further investigated in large samples.