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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

Comparison between OSEM SPECT and high spatial resolution planar imaging for breast cancer detection

Giuseppe De Vincentis1, Stefano Gervasi1, Roberto Pani1, Rosanna Pellegrini1, Alessandro De Cesare1, Silvia Remediani1 and Rita Massa1

1 Radiological Sciences, University La Sapienza, Rome, Italy

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Objectives: 99mTc-MIBI scintimammography (SM) plays an established role in breast lesions diagnosis, more than 1 cm sized. Aim of this study was to assess the clinical impact of OSEM SPECT Anger Camera imaging, compared with a dedicated HSR detector with external dimensions of 23x25x11 cm and about 4 mm of spatial resolution.

Methods: 40 patients (pts) were submitted to SM. Pts were studied on prone planar imaging (PI) on lateral and anterior view, 256x256 matrix,followed by SPECT scan, obtained on a 360 deg orbit, 3 deg per step,128x128 matrix and reconstructed by OSEM method (6 iterations). 21/40 of subject accepted to be submitted to HSR scan, so immediately after SPECT , cranio-caudal HSR scan under moderate compression were obtained.

Results: In the Anger camera population, 25 pts had benign lesions, whereas 15 had malignancies categorized as follows: 1 T1a, 7 T1c, 6 T2 and 1 lymph nodal recurrence. A total of 3 pts had lymph nodal involvement. In the HSR subgroup population 11/21 lesions were malignant (1 T1a, 7 T1c and 3 T2). SPECT was positive in 3/3 lymph node involvement, whereas PI only in 2. PI showed 14/15 true positive results (failed in the T1a lesion) and was falsely positive in 3/24 patients. SPECT showed positive findings in 15/15 malignancies whereas was falsely positive in 6/24 benign lesions. HSR correctly diagnosed all the 11 malignancies and was falsely positive in only 1/10 benign lesions. Interestingly HSR showed normal findings in 1 false positive PI and in 4 false positive SPECT.

Conclusions: OSEM SPECT improved SM sensitivity, but this result was obtained significantly lowering exam specificity. Our results suggest that dedicated HSR devices represent the more effective tool to improve SM effectiveness.





This Article
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Right arrow Articles by De Vincentis, G.
Right arrow Articles by Massa, R.
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Right arrow Articles by De Vincentis, G.
Right arrow Articles by Massa, R.