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Molecular breast imaging: use of a dual-head dedicated gamma camera to detect small breast tumors Hruska CB; Phillips SW; Whaley DH; Rhodes DJ; O'Connor MKAJR Am J Roentgenol 2008[Dec]; 191 (6): 1805-15OBJECTIVE: Molecular breast imaging with a single-head cadmium zinc telluride (CZT) gamma camera has previously been shown to have good sensitivity for the detection of small lesions. To further improve sensitivity, we developed a dual-head molecular breast imaging system using two CZT detectors to simultaneously acquire opposing breast views and reduce lesion-to-detector distance. We determined the incremental gain in sensitivity of molecular breast imaging with dual detectors. SUBJECTS AND METHODS: Patients with BI-RADS category 4 or 5 lesions < 2 cm that were identified on mammography or sonography and scheduled for biopsy underwent molecular breast imaging as follows: After injection of 740 MBq of technetium-99m ((99m)Tc) sestamibi, 10-minute craniocaudal and mediolateral oblique views of each breast were acquired. Blinded reviews were performed using images from both detectors 1 and 2 and images from detector 1 only (simulating a single-head system). Lesions were scored on a scale of 1-5; 2 or higher was considered positive. RESULTS: Of the 150 patients in the study, 128 cancers were confirmed in 88 patients. Averaging the results from the three blinded readers, the sensitivity of dual-head molecular breast imaging was 90% (115/128), whereas the sensitivity from review of only single-head molecular breast imaging was 80% (102/128). The sensitivity for the detection of cancers < or = 10 mm in diameter was 82% (50/61) for dual-head molecular breast imaging and 68% (41/61) for single-head molecular breast imaging. On average, 13 additional cancers were seen on dual-head images and the tumor uptake score increased by 1 or more in 60% of the identified tumors. CONCLUSION: Gains in sensitivity with the dual-head system molecular breast imaging are partially due to increased confidence in lesion detection. Molecular breast imaging can reliably detect breast lesions < 2 cm and dual-head molecular breast imaging can significantly increase sensitivity for subcentimeter lesions.|*Gamma Cameras[MESH]|*Technetium Tc 99m Sestamibi[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Breast Neoplasms/*diagnostic imaging[MESH]|Equipment Design[MESH]|Equipment Failure Analysis[MESH]|Female[MESH]|Humans[MESH]|Image Enhancement/*instrumentation[MESH]|Middle Aged[MESH]|Molecular Probe Techniques/*instrumentation[MESH]|Radionuclide Imaging[MESH]|Radiopharmaceuticals[MESH]|Reproducibility of Results[MESH]|Sensitivity and Specificity[MESH]|Single-Blind Method[MESH] |
