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Molecular scintigraphy (BSGI) for primary breast lesions

Posted Apr 22 2010 5:06am

Breast-specific -imaging (BSGI), also known as molecular breast imaging, is breast scintigraphy using a small-field-of-view -camera and 99mTc-sestamibi. Teh technology, especially the types of camers, continues to evolve. Although it is specific, 86%–89%,  it has a relatively low positive predictive value, especially in dense breast tissue.  In addition, correlation of the scintimammography images with ta mammogram is challenging.
BSGI can be  used in patients who have radiodense breast tissue, breast implants, or unexplained architectural distortion or in whom MRI is indicated but not possible. Other uses include evaluation of indeterminate areas identified by mammography or ultrasound, evaluation of multiple lesions or clusters of microcalcifications to aid in biopsy target selection, evaluation of the axillary region for node status in breast cancer patients, and postsurgical or posttherapeutic evaluation of mammographic tissue changes. In addition, BSGI can be used to investigate a palpable mass not demonstrated on mammogram or ultrasound, detect multicentric and multifocal disease or bilateral disease, determine the extent of the primary lesion, and screen a high-risk  However, the indications have not been fully defined and guideliens have not been issued.

Brem RF, Floerke A, Rapelyea J, Teal C, Kelly T, Mathur V. Breast specific gamma imaging as an adjunct imaging modality for the diagnosis of breast cancer. Radiology. 2008;247:651–657.

Zhou M, Johnson N, Gruner S, et al. Clinical utility of breast specific gamma imaging for evaluating disease extent in the newly diagnosed breast cancer patient. Am J Surg. 2009;197:159–163.[

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