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J Nucl Med. 2008; 49 (Supplement 1):341P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Accuracy of scintimammography and ultrasonography in loco-regional breast cancer recurrence in post mastectomy breast using ROC curve

Sharjeel Usmani1, Haider Ali khan1, Amir Javed1, Shihab al Mohannadi1 and Fawaz Abu al Huda1

1 Nuclear Medicine, Hussain Maki al Juma Centre for Specialized Surgery, Kuwait, Kuwait

1441

Objectives: To evaluate usefulness of 99mTc-MIBI Scintimammography (SMM) and ultrasonography (US) and in combination for the detection of loco-regional recurrence in post mastectomy breast.

Methods: 26 patients (mean age 47.15yr) evaluated for suspected local recurrence of breast cancer on clinical examination in post mastectomy breast. All patients received IV 740-1000 MBq of 99mTc-MIBI preferably in pedal vein. 5-10 min post injection planar images were obtained in prone lateral and supine anterior position followed by supine SPECT (64 projection, 64x 64 matrix, 30 sec/frame). MIBI uptake was scored as: 1: normal uptake; 2: focal low intense uptake (equivocal); 3: focal high intense uptake (positive). US of breast performed using 7.5MHz transducer. All patients underwent excision biopsy or FNAC for tissue diagnosis.

Results: Out of twenty-six patients, SMM was found true positive in 16 and true negative in 7. The sensitivity, specificity, PPV, NPV and accuracy were 88.8%, 87.5%, 94.11%, 77.77%, 88.46% respectively (p<0.001). In comparison US had Sens. 77.77%, Spec. 62.5%, PPV 82.35% NPV 55.55% and accuracy 73.07% (p<0.05). Significant correlation was found between SMM and US. (r=0.85). Using a combination of two test the combined Sens. was 100%, spec. 75%, PPV 90% NPV 100% and accuracy 92.3%. ROC curve analysis demonstrates that combination of SMM and US should be the test of choice for the investigation was significantly more accurate than either of the test alone.

Conclusions: For the diagnosis of loco-regional recurrence of breast cancer, the addition of SMM to US gives as significant increase in accuracy of breast imaging with acceptable degree of confidence.





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Right arrow Articles by Abu al Huda, F.