| The incidence of breast cancer accounted for first in female malignant tumor. The early diagnosis of breast cancer can significantly improve the prognosis and the life quality of patients with breast cancer. Due to the high quality of the radiological examination, the early diagnosis of breast cancer can be realized. The diagnosis ability of conventional imaging examination, including Ultrasound, MRI and mammography for breast cancer is limited though. Breast-specific gamma imaging (BSGI) is a functional imaging modality that has higher sensitivity than MRI and not affected by the breast density, as well as prosthesis implantation or scar. It has been more and more applied to clinical.ObjectivePreliminarily evaluating the value of BSGI in the diagnosis of breast cancer.MethodsThis paper collects a total of 446 cases from May 2014 to February 2016 in the Second Affiliated Hospital of Zhejiang University School of medicine. All cases were mammary gland disease and performed with BSGI, partly with ultrasound, mammography or MRI examination. Using the surgery or puncture pathology results as the gold standard, compare the results of BSGI with other imaging examination. Statistical analysis using SPSS 20 software, among different groups using chi square test, When P< 0.05, the difference was considered as the statistically significant.ResultsAfter analysis of 455 lesions, We found that the sensitivity of BSGI, ultrasound, mammography and MRI were 91.56%,81%,73%,85.90%; and specificity respectively 80.43%,81.33%,82.21%,71.79%; the positive predictive value were 82.1%,81.7%, 82.1% and 80.1%; the negative predictive value were 90.7%,81.5%,76.1% and 79.2%, the accuracy rate were 85.93%,85.65%,78.99% and 79.85%. The area of ROC curve of BSGI was 0.855, which was significantly higher than that of the latter three, and the difference was not significant between the three. The difference between BSIG and ultrasound, mammography and MRI was statistically significant (p< 0.05) in distinguish of benign and malignant lesions. For combined detecting, the sensitivity is higher when combined any two methods, but the specificity decreased. The combination of BSGI and mammography got the highest accuracy. Ultrasound plus mammography can reach 93.06% of sensitivity; the accuracy is superior to MRI plus BSGI. When the four methods used at the same time, the sensitivity is 100%, but the specificity is 48.1% only.The sensitivity of BSGI in intraductal carcinoma was only 75%, for non-special type of invasive ductal carcinoma, the sensitivity was 94.12%, the overall sensitivity was 91.56%. When the tumor is not larger than lcm, the sensitivity of BSGI was only 66.67%, lower than that in the B-ultrasound (90%). In tumors between 2cm to 5cm, the sensitivity of BSGI was 96.49%. And when the tumor is larger than 5cm, the sensitivity of BSGI was 100%, significantly higher than the B-ultrasound. The sensitivity of MRI is slightly higher than BSGI only if the tumor is not larger than lcm. The evaluation of axillary lymph node in breast cancer with BSGI was not effectively.The sensitivity was only 18.18% in BSGI while 46.15% in B-ultrasound.ConclusionsThe proportion of malignant lesions increased with age. The sensitivity of BSGI was not significantly affected by age. In a single examination, BSGI was superior to other tests in the identification of breast cancer. The sensitivity and specificity of BSGI imaging were higher than that of MRI, and the accuracy was even higher when combined with mammography. Multiple imaging examinations can improve the sensitivity and increase the detection rate of lesions, but it is less accurate because of the decrease of specificity. BSGI has a high sensitivity to the non special types of invasive ductal carcinoma, and is limited in the diagnosis of ductal carcinoma. When the tumor was more than 2cm, the sensitivity of BSGI was higher. For evaluation of axillary lymph node in breast cancer, BSGI is far less sensitive than the B ultrasound. |
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