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. 2008 Oct;196(4):470-6.
doi: 10.1016/j.amjsurg.2008.06.005. Epub 2008 Aug 23.

Scientific Impact Recognition Award: Molecular breast imaging: a review of the Mayo Clinic experience

Carrie B Hruska  1 , Judy C Boughey, Stephen W Phillips, Deborah J Rhodes, Dietlind L Wahner-Roedler, Dana H Whaley, Amy C Degnim, Michael K O'Connor
Affiliations

Scientific Impact Recognition Award: Molecular breast imaging: a review of the Mayo Clinic experience

Carrie B Hruska et al. Am J Surg. 2008 Oct.

Abstract

Background: Molecular breast imaging (MBI) depicts functional uptake of targeted radiotracers in the breast using dedicated gamma cameras.

Methods: MBI studies were performed under several institutional protocols evaluating the use of MBI in screening and diagnosis.

Results: By using a single-head system, sensitivity for breast cancer detection was 85% (57 of 67) overall and 29% for tumors 5 mm or less in diameter. Sensitivity improved to 91% (117 of 128) overall and 69% for tumors 5 mm or less using a dual-head system. In 650 high-risk patients undergoing breast cancer screening, MBI detected 7 cancers, 5 of which were missed on mammography. In 24 of 149 (16%) breast cancer patients MBI detected additional disease not seen on mammography. The sensitivity of MBI was 88% (83 of 94) for invasive ductal carcinoma, 79% (23 of 29) for invasive lobular carcinoma, and 89% (25 of 28) for ductal carcinoma in situ.

Conclusions: MBI can detect invasive ductal carcinoma, ductal carcinoma in situ, and invasive lobular carcinoma. It has a promising role in evaluating the extent of disease and multifocal disease in the breast for surgical treatment planning.

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Figures

Figure 1
Figure 1
Dual-head Molecular Breast Imaging system comprising two cadmium zinc telluride detectors mounted on a modified mammographic gantry.
Figure 2
Figure 2
Mammogram (MLO view at left) demonstrating a 20 mm invasive ductal carcinoma (IDC). The corresponding MBI study (MLO view at right) demonstrated an additional 10 mm IDC occult on mammogram.
Figure 3
Figure 3
An example of a patient with concordant MBI (left) and breast MRI (Right) findings. MBI shows linear focal abnormal tracer uptake in the posterolateral left breast with orientation towards the nipple. There are 3 foci of intense tracer uptake suggesting a combination of invasive breast cancer and DCIS. MRI shows an irregular enhancing mass in the outer breast measuring 4.6cm × 1.8cm × 2.2cm.
Figure 4
Figure 4
A 38-year-old female presented with palpable left breast mass. Biopsy revealed IDC. Shown are the dual-head MBI images, which demonstrate a focal area of intense tracer uptake, with an associated tail of segmental tracer uptake extending posteriorly away from the mass, consistent with IDC and associated DCIS. Additionally a second focus of biopsy proven IDC is seen by the moderate focal uptake in the posterior lower outer quadrant of the left breast.
See this image and copyright information in PMC

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