Evaluation of a high-resolution, breast-specific, small-field-of view gamma camera for the detection of breast cancer

Purpose: The purpose of our study is to review the state of the art in nuclear medicine imaging of the breast (scintimammography) and to evaluate a novel, high-resolution, breast-specific gamma camera (HRBGC) for the detection of suspicious breast lesions. Materials and Methods: Fifty patients with 58 breast lesions in whom a scintimammogram was clinically indicated were prospectively evaluated with a general-purpose gamma camera and a HRBGC prototype. Nuclear studies were prospectively classified as negative (normal/benign) or positive (suspicious/malignant) by two radiologists, blinded to marnmographic and histologic results with both the conventional and high-resolution. All lesions were confirmed by pathology. Results: Included in this study were 30 benign and 28 malignant lesions. The sensitivity for detection of breast cancer was 64.3% (18/28) with the conventional camera and 78.6% (22/28) with the HRBGC. Specificity of both systems was 93.3% (28/30). In the 18 nonpalpable cancers, sensitivity was 55.5% (10/18) and 72.2% (13/18) with the generalpurpose camera and HRBGC, respectively. In cancers less than or equal to 1cm, 7 of 15 were detected with the general-purpose camera and 10 of 15 with the HRBGC. Four of the cancers (median size, 8.5 mm) detected with the HRBGC were missed by the conventional camera. Conclusion: Evaluation of indeterminate breasts lesions with a high resolution, breast-specific gamma camera results in improved sensitivity for the detection of cancer with greater improvement demonstrated in nonpalpable and less than or equal to 1 cm cancers. (C) 2002 Elsevier Science B.V. All rights reserved.