Breast cancer other imaging studies: Difference between revisions
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==Overview== | ==Overview== | ||
Other diagnostic studies for breast cancer include modified [[Magnetic resonance imaging|MRI]] utilities (high-field strength MRI, magnetic resonance [[spectroscopy]], and diffusion weighted imaging, breast-specific [[Nuclear medicine|gamma imaging]], [[Positron emission tomography|positron emission]] mammography, scintimammography, [[Thermography (Sympathetic galvonic skin studies)|thermography]] and bone scan. | Other diagnostic studies for breast cancer include modified [[Magnetic resonance imaging|MRI]] utilities (high-field strength MRI, magnetic resonance [[spectroscopy]], and diffusion weighted imaging, breast-specific [[Nuclear medicine|gamma imaging]], [[Positron emission tomography|positron emission]] mammography, scintimammography, [[Thermography (Sympathetic galvonic skin studies)|thermography]] and bone scan. | ||
==Mammography== | |||
Please | |||
==Scintimammography or breast-specific gamma imaging (BSGI)== | ==Scintimammography or breast-specific gamma imaging (BSGI)== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2], Ammu Susheela
Overview
Other diagnostic studies for breast cancer include modified MRI utilities (high-field strength MRI, magnetic resonance spectroscopy, and diffusion weighted imaging, breast-specific gamma imaging, positron emission mammography, scintimammography, thermography and bone scan.
Mammography
Please
Scintimammography or breast-specific gamma imaging (BSGI)
- Gamma cameras with 2 to 3 mm in-plane resolution in a mammographic configuration are used
- Concept of BSGI is based on the accumulation of technetium-99m sestamibi in intracellular mitochondria of breast cancers cells.[1]
- Compared to normal cells there is an increased number if intracellular mitochondria in breast cancer cells.[2]
- Procedure
- First 25 mCi of technetium-99m sestamibi is being injected intravenously
- Following the injection of the radioisotope, The patient is scanned for 5 to 10 minutes.
- Mild breast compression is applied as of conventional mammography.
- Craniocaudal and mediolateral oblique views for each breast
- This is an adjuvant imaging method and hence images will be interpreted with respect to the patient's mammograms, ultrasounds, and clinical findings.[3]
- If indicated, BSGI compatible biopsy system is available to direct tissue sampling for the patients with small lesions not seen on other imaging modalities.
- Compared to MRI, BSGI showed an equal sensitivity and higher specificity for the detection of breast cancer.
- BSGI is recommended for use in the preoperative assessment of disease extension in breast cancer patients. or:
- To check breast lumps that do not show up clearly on a mammogram because of:
- Scar tissue from previous surgery or radiation therapy
- Dense breast tissue
- Breast implants
- When multiple tumors are seen in the breast
- To scan the lymph nodes in the armpit (axilla) to see if they contain cancer
- Because of a very limited available DATA at the moment, BSGI is not recommended for screening or as a tool to exclude the likelihood of malignancy in suspicious breast masses or abnormal mammography.
Bone Scan
- A bone scan uses bone-seeking radioactive materials (radiopharmaceuticals) and a computer to create a picture of the bones. It is used to see if breast cancer has spread (metastasized) to the bones.[4]
- A bone scan may be done if:[5]
- Alkaline phosphatase in the blood is increased
- There are lymph nodes in the armpit (axillary lymph nodes) that can be felt
- The primary breast tumor is larger than 5 cm
- The woman has aches and pains that may be caused by bone metastases
- A bone scan is not done in women who have stage I breast cancer.
Thermography
- Digital infrared thermal imaging (DITI) is a type of thermography which is used in the screening of breast cancer
- An infrared thermal camera takes pictures of the areas of different temperature in the breasts.[6]
- The camera displays these patterns as a sort of heat map.
- Since the presence of cancerous growth is associated with the excessive formation of blood vessels and inflammation in the breast tissue.
- On the infrared images, these higher temperatures could be detected.[7]
Benefits
- Non-invasive procedure
- Non-contact procedure (does not compress the breast)
- No exposure to radiation, (safe)
- It can detect vascular changes in breast tissue associated with breast cancer many years in advance of other methods of screening.
- It can be used for all women, including those with dense breast tissue and breast implants.
- Hormonal changes do not affect results.
- High false-positive rate
- High false-negative rate
- Rarely covered by medical insurance
- The high false-positive and false-negative rates associated with thermography often mean that the woman will need a standard mammogram anyway.
Positron emission mammography
- PEM is still under investigation.
- High-resolution fluorodeoxyglucose PEM with compression with 2 mm in-plane resolution has been studied for detection of small malignancies [10] [11]
- The procedure
- This is a modified PET scan method and hence patients are prepared as for PET scan.
- Mild compression as of conventional mammography
- Craniocaudal and mediolateral oblique views for each breast
- This is an adjuvant imaging method and hence images will be interpreted with respect to the patient's mammograms, ultrasounds, and clinical findings.
- if indicated, PEM-compatible biopsy system is available to direct tissue sampling for the patients with small lesions not seen on other imaging modalities.
- Sensitivity 86 to 91 percent
- Specificity91 to 93 percent
- Major drawback is that PEM cannot reliably detect low-grade malignancies.
- Hence, PEM is not recommended for screening or as a tool to exclude the likelihood of malignancy in suspicious breast masses or abnormal mammography.
- Nevertheless PEM is promising for the preoperative assessment of disease extension[12]
Reference
- ↑ Jones EA, Phan TD, Blanchard DA, Miley A (2009) Breast-specific gamma-imaging: molecular imaging of the breast using 99mTc-sestamibi and a small-field-of-view gamma-camera. J Nucl Med Technol 37 (4):201-5. DOI:10.2967/jnmt.109.063537 PMID: 19914975
- ↑ Rechtman LR, Lenihan MJ, Lieberman JH, Teal CB, Torrente J, Rapelyea JA et al. (2014) Breast-specific gamma imaging for the detection of breast cancer in dense versus nondense breasts. AJR Am J Roentgenol 202 (2):293-8. DOI:10.2214/AJR.13.11585 PMID: 24450668
- ↑ Brem RF, Floerke AC, Rapelyea JA, Teal C, Kelly T, Mathur V (2008) Breast-specific gamma imaging as an adjunct imaging modality for the diagnosis of breast cancer. Radiology 247 (3):651-7. DOI:10.1148/radiol.2473061678 PMID: 18487533
- ↑ Sugihara T, Koizumi M, Koyama M, Terauchi T, Gomi N, Ito Y et al. (2017) Bone metastases from breast cancer: associations between morphologic CT patterns and glycolytic activity on PET and bone scintigraphy as well as explorative search for influential factors. Ann Nucl Med 31 (10):719-725. DOI:10.1007/s12149-017-1202-3 PMID: 28864931
- ↑ Cook GJ, Azad GK, Goh V (2016) Imaging Bone Metastases in Breast Cancer: Staging and Response Assessment. J Nucl Med 57 Suppl 1 ():27S-33S. DOI:10.2967/jnumed.115.157867 PMID: 26834098
- ↑ Omranipour R, Kazemian A, Alipour S, Najafi M, Alidoosti M, Navid M et al. (2016) Comparison of the Accuracy of Thermography and Mammography in the Detection of Breast Cancer. Breast Care (Basel) 11 (4):260-264. DOI:10.1159/000448347 PMID: 27721713
- ↑ Mambou SJ, Maresova P, Krejcar O, Selamat A, Kuca K (2018) Breast Cancer Detection Using Infrared Thermal Imaging and a Deep Learning Model. Sensors (Basel) 18 (9):. DOI:10.3390/s18092799 PMID: 30149621
- ↑ Brkljacić B, Miletić D, Sardanelli F (2013) Thermography is not a feasible method for breast cancer screening. Coll Antropol 37 (2):589-93. PMID: 23941008
- ↑ Kolarić D, Herceg Z, Nola IA, Ramljak V, Kulis T, Holjevac JK et al. (2013) Thermography--a feasible method for screening breast cancer? Coll Antropol 37 (2):583-8. PMID: 23941007
- ↑ Schilling K, Narayanan D, Kalinyak JE, The J, Velasquez MV, Kahn S et al. (2011) Positron emission mammography in breast cancer presurgical planning: comparisons with magnetic resonance imaging. Eur J Nucl Med Mol Imaging 38 (1):23-36. DOI:10.1007/s00259-010-1588-9 PMID: 20871992
- ↑ Kalles V, Zografos GC, Provatopoulou X, Koulocheri D, Gounaris A (2013) The current status of positron emission mammography in breast cancer diagnosis. Breast Cancer 20 (2):123-30. DOI:10.1007/s12282-012-0433-3 PMID: 23239242
- ↑ Glass SB, Shah ZA (2013) Clinical utility of positron emission mammography. Proc (Bayl Univ Med Cent) 26 (3):314-9. PMID: 23814402