Abstract
Objectives
This study investigated factors that could affect background uptake of 99mTc- methoxyisobutylisonitrile (MIBI) on normal breast by breast-specific gamma imaging (BSGI). In addition, the impact of background 99mTc-MIBI uptake on the diagnostic performance of BSGI was further investigated.
Methods
One hundred forty-five women with unilateral breast cancer who underwent BSGI, MRI, and mammography were retrospectively enrolled. Background uptake on BSGI was evaluated qualitatively and quantitatively. Patients were classified into non-dense and dense breast groups according to mammographic breast density. Background parenchymal enhancement (BPE) was rated according to BI-RADS classification. The relationship of age, menopausal status, mammographic breast density, and BPE with background 99mTc-MIBI uptake was analyzed.
Results
Heterogeneous texture and high background uptake ratio on BSGI were significantly correlated with younger age (p < 0.001, respectively), premenopausal status (p < 0.001 and p = 0.003), dense breast (p < 0.001, respectively), and marked BPE (p < 0.001, respectively). On multivariate analysis, only BPE remained a significant factor for background MIBI uptake (p < 0.001).There was a significant reduction in positive predictive value (p = 0.024 and p = 0.002) as background MIBI uptake and BPE grade increased.
Conclusions
BPE on MRI was the most important factor for background MIBI uptake on BSGI. High background MIBI uptake or marked BPE can diminish the diagnostic performance of BSGI.
Key Points
• Age, menopause, density, and background parenchymal enhancement affect background MIBI uptake.
• BPE is an independent factor for background MIBI uptake on BSGI.
• Marked BPE may impair BSGI interpretation.
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Abbreviations
- BSGI:
-
Breast-specific gamma imaging
- BPE:
-
Background parenchymal enhancement
- BI-RADS:
-
Breast Imaging-Reporting and Data System
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Acknowledgments
The scientific guarantor of this publication is Bom Sahn Kim. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This research was supported by grants from Ewha Womans University Research (1-2014-0642-001-1) and National Research Foundation (2012R1A1A1012913 and 2012M3A9B6055379) of South Korea. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.
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Yoon, HJ., Kim, Y., Lee, J.E. et al. Background 99mTc-methoxyisobutylisonitrile uptake of breast-specific gamma imaging in relation to background parenchymal enhancement in magnetic resonance imaging. Eur Radiol 25, 32–40 (2015). https://doi.org/10.1007/s00330-014-3400-x
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DOI: https://doi.org/10.1007/s00330-014-3400-x