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Comparison of 99mTc-MIBI scintigraphy, ultrasound, and mammography for the diagnosis of BI-RADS 4 category lesions
hongbiao liu
Zhejiang University School of Medicine Second Affiliated Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5797-8366
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Background: We sought to determine the diagnostic efficacy of Breast-specific gamma imaging (BSGI) in Chinese women with BI-RADS 4 category lesions and to compare this efficacy to that of ultrasound/mammography.
Methods: We retrospectively analyzed data from 177 women that had undergone BSGI of BI-RADS 4 category lesions originally detected via ultrasound and/or mammography.
Results: Of these 177 cases, 117 (66.1%) were malignant lesions and 60 (33.9%) were benign. The sensitivity, specificity, positive predictive values, and negative predictive values of BSGI were 94.9% (111/117), 78.3% (47/60), 89.5% (111/124), and 88.7% (47/53), respectively. The specificity and positive predictive values for mammography were 48.3% (29/60) and 77.5% (107/138), while for ultrasound they were 53.3% (32/60) and 79.6% (109/137), respectively. The sensitivity and specificity of BSGI for the detection of lesions ≤1 cm in size were 90.9% (10/11) and 88.0% (22/25), respectively, while for breast lesions ＞1cm in size these values were 94.3% (100/106) and 71.4% (25/35), respectively. In addition, BSGI sensitivity and specificity values for dense breast tissue were 94.0% (79/84)and 78.0% (39/50), respectively, whereas for non-dense breast tissue these vales were 97.0% (32/33) and 80.0% (8/10), respectively. The sensitivity of BSGI for invasive ductal carcinomas (IDC) and ductal carcinomas in situ (DCIS) was 98.9% (95/96) and 75.0% (9/12), respectively. The tumor to normal tissue ratio of BSGI for malignant lesions was significantly higher than for benign lesions (2.18±1.17 vs 1.66±0.40, t=7.56, P＜0.05).
Conclusions: These results indicate that BSGI is highly sensitive for the detection of such lesions, achieving good positive/negative predictive values. This suggests that for IDC in particular, BSGI is superior to ultrasound and mammography for the diagnosis of BI-RADS 4 category lesions, although this was less apparent for the diagnosis of DCIS lesions. BSGI exhibited excellent performance in dense breast tissue and for the detection of lesions ≤ 1 cm in size.
Keywords
Breast-specific gamma imaging/BSGI; Mammography; Ultrasound; Breast cancer
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Posted 17 Apr, 2020
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On 13 Apr, 2020
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On 12 Apr, 2020
Editor invited
On 12 Apr, 2020
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Editorial decision: Minor revision
On 07 Apr, 2020
Editor assigned
On 30 Mar, 2020
Submission checks complete
On 29 Mar, 2020
Editor invited
On 29 Mar, 2020
No comments provided
Editorial decision: Major revision
On 26 Feb, 2020
Review #3 received
Received 17 Feb, 2020
Review #2 received
Received 14 Feb, 2020
Review #1 received
Received 10 Feb, 2020
Reviewer #3 agreed
On 02 Feb, 2020
Reviewer #2 agreed
On 31 Jan, 2020
Reviewer #1 agreed
On 27 Jan, 2020
Editor assigned
On 21 Jan, 2020
Reviewers invited
Invitations sent on 21 Jan, 2020
Submission checks complete
On 14 Jan, 2020
Editor invited
On 14 Jan, 2020
First submitted
On 08 Jan, 2020
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Comparison of 99mTc-MIBI scintigraphy, ultrasound, and mammography for the diagnosis of BI-RADS 4 category lesions
hongbiao liu
Zhejiang University School of Medicine Second Affiliated Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5797-8366
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 17 Apr, 2020
No community comments so far
Editor assigned
On 13 Apr, 2020
Submission checks complete
On 12 Apr, 2020
Editor invited
On 12 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 07 Apr, 2020
Editor assigned
On 30 Mar, 2020
Submission checks complete
On 29 Mar, 2020
Editor invited
On 29 Mar, 2020
No comments provided
Editorial decision: Major revision
On 26 Feb, 2020
Review #3 received
Received 17 Feb, 2020
Review #2 received
Received 14 Feb, 2020
Review #1 received
Received 10 Feb, 2020
Reviewer #3 agreed
On 02 Feb, 2020
Reviewer #2 agreed
On 31 Jan, 2020
Reviewer #1 agreed
On 27 Jan, 2020
Editor assigned
On 21 Jan, 2020
Reviewers invited
Invitations sent on 21 Jan, 2020
Submission checks complete
On 14 Jan, 2020
Editor invited
On 14 Jan, 2020
First submitted
On 08 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: We sought to determine the diagnostic efficacy of Breast-specific gamma imaging (BSGI) in Chinese women with BI-RADS 4 category lesions and to compare this efficacy to that of ultrasound/mammography.
Methods: We retrospectively analyzed data from 177 women that had undergone BSGI of BI-RADS 4 category lesions originally detected via ultrasound and/or mammography.
Results: Of these 177 cases, 117 (66.1%) were malignant lesions and 60 (33.9%) were benign. The sensitivity, specificity, positive predictive values, and negative predictive values of BSGI were 94.9% (111/117), 78.3% (47/60), 89.5% (111/124), and 88.7% (47/53), respectively. The specificity and positive predictive values for mammography were 48.3% (29/60) and 77.5% (107/138), while for ultrasound they were 53.3% (32/60) and 79.6% (109/137), respectively. The sensitivity and specificity of BSGI for the detection of lesions ≤1 cm in size were 90.9% (10/11) and 88.0% (22/25), respectively, while for breast lesions ＞1cm in size these values were 94.3% (100/106) and 71.4% (25/35), respectively. In addition, BSGI sensitivity and specificity values for dense breast tissue were 94.0% (79/84)and 78.0% (39/50), respectively, whereas for non-dense breast tissue these vales were 97.0% (32/33) and 80.0% (8/10), respectively. The sensitivity of BSGI for invasive ductal carcinomas (IDC) and ductal carcinomas in situ (DCIS) was 98.9% (95/96) and 75.0% (9/12), respectively. The tumor to normal tissue ratio of BSGI for malignant lesions was significantly higher than for benign lesions (2.18±1.17 vs 1.66±0.40, t=7.56, P＜0.05).
Conclusions: These results indicate that BSGI is highly sensitive for the detection of such lesions, achieving good positive/negative predictive values. This suggests that for IDC in particular, BSGI is superior to ultrasound and mammography for the diagnosis of BI-RADS 4 category lesions, although this was less apparent for the diagnosis of DCIS lesions. BSGI exhibited excellent performance in dense breast tissue and for the detection of lesions ≤ 1 cm in size.
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Figure 5