Smartest Doc
Evaluation of Molecular Breast Imaging in Women Undergoing Myocardial Perfusion Imaging with Tc-99m Sestamibi
Journal of Women's Health, 05/18/2012
Hruska CB et al. – The addition of MBI to clinically indicated stress myocardial perfusion imaging studies in women results in a high diagnostic yield of newly detected breast cancers while generating a low rate of additional unnecessary workup.
Methods- MBI was offered to women receiving Tc–99m sestamibi injection for myocardial perfusion stress testing.
- During the required waiting period after stress isotope injection, MBI was performed using a dedicated breast imaging gamma camera system.
- MBI examinations were interpreted by breast radiologists, with review of a recent mammogram in cases with positive MBI.
- Of 322 women enrolled, 313 completed MBI, comprising 5 with known breast cancer, 2 with known high–risk benign breast lesions, and 306 who were asymptomatic for breast disease with a recent negative mammogram.
- Analysis was limited to the 306 patients with no known breast disease. MBI was positive in 22 of 306, giving a recall rate of 7.2% (95% confidence interval [CI] 4.8–10.6].
- MBI detected 4 new cancers, resulting in a supplemental diagnostic yield of 13.1/1000 women screened (95% CI 5.1–33.2).
- The number of cancers diagnosed per abnormal MBI examinations (PPV1) was 18% (4 of 22) (95% CI 7.3–38.5), and the number diagnosed per MBI–prompted biopsies (PPV3) was 44% (4 of 9) (95% CI 18.9–73.3).
