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Breast-specific gamma imaging or ultrasonography as adjunct imaging diagnostics in women with mammographically dense breasts

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Abstract

Background

Mammography (MMG) shows decreased diagnostic accuracy in dense breast tissue, and thus, ultrasonography (US) and breast-specific gamma imaging (BSGI) have gradually been adopted for women with mammographically dense breasts. However, these two adjunct modalities have not been directly compared in previous studies. Hence, we investigated the adjunctive efficacy of US and BSGI in mammographically dense breasts.

Methods

This retrospective, comparative study recruited women with mammographically dense breasts. All enrolled women underwent US and BSGI as adjunctive imaging, and the comparative sensitivity, specificity, and diagnostic accuracy of combined MMG plus BSGI versus MMG plus US were evaluated. McNemar’s test was used for paired binary data in this comparative analysis.

Results

From April 2013 to April 2016, 364 women with mammographically dense breasts and a final surgical or biopsy pathological diagnosis were recruited, comprising 218 cases of malignant disease (59.9%) and 146 cases of benign disease (40.1%). There was no difference between BSGI and US in enhancing the sensitivity of MMG diagnosis (Se-Difference 3.2%, p = 0.23), but the diagnostic specificity of MMG plus BSGI was superior to that of MMG plus US (Sp-Difference 10.3%, p = 0.003). The area under the ROC curve showed that MMG plus BSGI had better diagnostic accuracy than MMG plus US (0.90 vs. 0.83, p = 0.0019).

Conclusions

For women with mammographically dense breasts, MMG plus BSGI or US can improve the diagnostic accuracy. In addition, BSGI has high specificity and could reduce invasive biopsies and thus may represent a viable diagnostic imaging alternative for mammographically dense breasts.

Key Points

• Both BSGI and US can be applied as adjunct imaging diagnostics in women with mammographically dense breasts.

• The diagnostic accuracy of MMG plus BSGI was higher than that of MMG plus US.

• BSGI has the potential to be used as an adjunct diagnostic modality in women with mammographically dense breasts.

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Abbreviations

AUC:

Area under the curve

BSGI:

Breast-specific gamma imaging

MMG:

Mammography

MRI:

Magnetic resonance imaging

Se:

Sensitivity

Sp:

Specificity

US:

Ultrasound

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Acknowledgments

The authors would like to thank the members of the research group for their useful discussions.

Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. Zhigang Zhang and Weilan Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310009, China

    Zhigang Zhang, Xiaochen Wang, Xiuyan Yu, Zhigang Chen & Jian Huang

  2. Department of Gynecology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China

    Zhigang Zhang & Ying Zhu

  3. Department of General surgery, Changxing County People’s Hospital, Changxing, 313100, China

    Weilan Wang

  4. Department of Nuclear Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China

    Hongwei Zhan

  5. Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China

    Baizhou Li

Authors
  1. Zhigang Zhang
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  2. Weilan Wang
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  3. Xiaochen Wang
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  4. Xiuyan Yu
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  5. Ying Zhu
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  6. Hongwei Zhan
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  7. Zhigang Chen
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  8. Baizhou Li
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  9. Jian Huang
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Contributions

Study conception and design: Jian Huang and Zhigang Zhang. Acquisition, analysis, or interpretation of data: Weilan Wang, Xiaochen Wang, Xiuyan Yu, Ying Zhu, Hongwei Zhan, Zhigang Chen, and Baizhou Li. Drafting and revising the article: Jian Huang, Zhigang Zhang, and Weilan Wang.

Corresponding author

Correspondence to Jian Huang.

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Guarantor

The scientific guarantor of this publication is Jian Huang.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

This study was approved by Second Affiliated Hospital of Zhejiang University School of Medicine ethics committee and all the patients had given written informed consent.

Methodology

• retrospective

• observational

• performed at one institution

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Zhang, Z., Wang, W., Wang, X. et al. Breast-specific gamma imaging or ultrasonography as adjunct imaging diagnostics in women with mammographically dense breasts. Eur Radiol 30, 6062–6071 (2020). https://doi.org/10.1007/s00330-020-06950-2

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  • DOI: https://doi.org/10.1007/s00330-020-06950-2

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