Half-time Tc-99m sestamibi imaging with a direct conversion molecular breast imaging system

Carrie B Hruska, Amy Lynn Conners, Katie N. Jones, Amanda L. Weinmann, Ravi K. Lingineni, Rickey E. Carter, Deborah Rhodes, Michael K. O'Connor

Research output: Contribution to journalArticle

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Abstract

Background In an effort to reduce necessary acquisition time to perform molecular breast imaging (MBI), we compared diagnostic performance of MBI performed with standard 10-min-per-view acquisitions and half-time 5-min-per-view acquisitions, with and without wide beam reconstruction (WBR) processing. Methods Eighty-two bilateral, two-view MBI studies were reviewed. Studies were performed with 300 MBq Tc-99 m sestamibi and a direct conversion molecular breast imaging (DC-MBI) system. Acquisitions were 10 min-per-view; the first half of each was extracted to create 5-min-perview datasets, and WBR processing was applied. The 10-min-,5-min-,and 5-min-per-view WBR studies were independently interpreted in a randomized, blinded fashion by two radiologists. Assessments of 1 to 5 were assigned; 4 and 5 were considered test positive. Background parenchymal uptake, lesion type, distribution of non-mass lesions, lesion intensity, and image quality were described. Results Considering detection of all malignant and benign lesions, 5 min-per-view MBI had lower sensitivity (mean of 70%vs.85% (p ≤ 0.04) for two readers) and lower area under curve (AUC) (mean of 92.7 vs. 99.6, p ≤ 0.01) but had similar specificity (p =1.0). WBR processing did not alter sensitivity, specificity, or AUC obtained at 5 min-per-view. Overall agreement in final assessment between 5-min-per-view and 10-min-per-view acquisition types was near perfect (κ = 0.82 to 0.89); however, fair to moderate agreement was observed for assessment category 3 (probably benign) (κ = 0.24 to 0.48). Of 33 malignant lesions, 6 (18%) were changed from assessment of 4 or 5 with 10-min-per-view MBI to assessment of 3 with 5-min-per-view MBI. Image quality of 5-min-per-view studies was reduced compared to 10-min-per-view studies for both readers (3.24 vs. 3.98, p < 0.0001 and 3.60 vs. 3.91, p < 0.0001).WBR processing improved image quality for one reader (3.85 vs. 3.24, p < 0.0001).Conclusions Although similar radiologic interpretations were obtained with 10-min-and 5-min-per-view DC-MBI, resulting in substantial agreement in final assessment, notable exceptions were found: (1) perceived image quality at 5 min-per-view was lower than that for 10-min-perview studies and (2) in a number of cases, assessment was downgraded from a recommendation of biopsy to that of short interval follow-up.

Original languageEnglish (US)
JournalEJNMMI Research
Volume4
Issue number1
DOIs
StatePublished - 2014

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Molecular Imaging
Breast
Area Under Curve
Biopsy
Sensitivity and Specificity

Keywords

  • Breast cancer
  • CZT
  • Direct conversion
  • Dose reduction
  • Molecular breast imaging
  • Wide beam reconstruction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Half-time Tc-99m sestamibi imaging with a direct conversion molecular breast imaging system. / Hruska, Carrie B; Conners, Amy Lynn; Jones, Katie N.; Weinmann, Amanda L.; Lingineni, Ravi K.; Carter, Rickey E.; Rhodes, Deborah; O'Connor, Michael K.

In: EJNMMI Research, Vol. 4, No. 1, 2014.

Research output: Contribution to journalArticle

Hruska, Carrie B ; Conners, Amy Lynn ; Jones, Katie N. ; Weinmann, Amanda L. ; Lingineni, Ravi K. ; Carter, Rickey E. ; Rhodes, Deborah ; O'Connor, Michael K. / Half-time Tc-99m sestamibi imaging with a direct conversion molecular breast imaging system. In: EJNMMI Research. 2014 ; Vol. 4, No. 1.
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title = "Half-time Tc-99m sestamibi imaging with a direct conversion molecular breast imaging system",
abstract = "Background In an effort to reduce necessary acquisition time to perform molecular breast imaging (MBI), we compared diagnostic performance of MBI performed with standard 10-min-per-view acquisitions and half-time 5-min-per-view acquisitions, with and without wide beam reconstruction (WBR) processing. Methods Eighty-two bilateral, two-view MBI studies were reviewed. Studies were performed with 300 MBq Tc-99 m sestamibi and a direct conversion molecular breast imaging (DC-MBI) system. Acquisitions were 10 min-per-view; the first half of each was extracted to create 5-min-perview datasets, and WBR processing was applied. The 10-min-,5-min-,and 5-min-per-view WBR studies were independently interpreted in a randomized, blinded fashion by two radiologists. Assessments of 1 to 5 were assigned; 4 and 5 were considered test positive. Background parenchymal uptake, lesion type, distribution of non-mass lesions, lesion intensity, and image quality were described. Results Considering detection of all malignant and benign lesions, 5 min-per-view MBI had lower sensitivity (mean of 70{\%}vs.85{\%} (p ≤ 0.04) for two readers) and lower area under curve (AUC) (mean of 92.7 vs. 99.6, p ≤ 0.01) but had similar specificity (p =1.0). WBR processing did not alter sensitivity, specificity, or AUC obtained at 5 min-per-view. Overall agreement in final assessment between 5-min-per-view and 10-min-per-view acquisition types was near perfect (κ = 0.82 to 0.89); however, fair to moderate agreement was observed for assessment category 3 (probably benign) (κ = 0.24 to 0.48). Of 33 malignant lesions, 6 (18{\%}) were changed from assessment of 4 or 5 with 10-min-per-view MBI to assessment of 3 with 5-min-per-view MBI. Image quality of 5-min-per-view studies was reduced compared to 10-min-per-view studies for both readers (3.24 vs. 3.98, p < 0.0001 and 3.60 vs. 3.91, p < 0.0001).WBR processing improved image quality for one reader (3.85 vs. 3.24, p < 0.0001).Conclusions Although similar radiologic interpretations were obtained with 10-min-and 5-min-per-view DC-MBI, resulting in substantial agreement in final assessment, notable exceptions were found: (1) perceived image quality at 5 min-per-view was lower than that for 10-min-perview studies and (2) in a number of cases, assessment was downgraded from a recommendation of biopsy to that of short interval follow-up.",
keywords = "Breast cancer, CZT, Direct conversion, Dose reduction, Molecular breast imaging, Wide beam reconstruction",
author = "Hruska, {Carrie B} and Conners, {Amy Lynn} and Jones, {Katie N.} and Weinmann, {Amanda L.} and Lingineni, {Ravi K.} and Carter, {Rickey E.} and Deborah Rhodes and O'Connor, {Michael K.}",
year = "2014",
doi = "10.1186/2191-219X-4-5",
language = "English (US)",
volume = "4",
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T1 - Half-time Tc-99m sestamibi imaging with a direct conversion molecular breast imaging system

AU - Hruska, Carrie B

AU - Conners, Amy Lynn

AU - Jones, Katie N.

AU - Weinmann, Amanda L.

AU - Lingineni, Ravi K.

AU - Carter, Rickey E.

AU - Rhodes, Deborah

AU - O'Connor, Michael K.

PY - 2014

Y1 - 2014

N2 - Background In an effort to reduce necessary acquisition time to perform molecular breast imaging (MBI), we compared diagnostic performance of MBI performed with standard 10-min-per-view acquisitions and half-time 5-min-per-view acquisitions, with and without wide beam reconstruction (WBR) processing. Methods Eighty-two bilateral, two-view MBI studies were reviewed. Studies were performed with 300 MBq Tc-99 m sestamibi and a direct conversion molecular breast imaging (DC-MBI) system. Acquisitions were 10 min-per-view; the first half of each was extracted to create 5-min-perview datasets, and WBR processing was applied. The 10-min-,5-min-,and 5-min-per-view WBR studies were independently interpreted in a randomized, blinded fashion by two radiologists. Assessments of 1 to 5 were assigned; 4 and 5 were considered test positive. Background parenchymal uptake, lesion type, distribution of non-mass lesions, lesion intensity, and image quality were described. Results Considering detection of all malignant and benign lesions, 5 min-per-view MBI had lower sensitivity (mean of 70%vs.85% (p ≤ 0.04) for two readers) and lower area under curve (AUC) (mean of 92.7 vs. 99.6, p ≤ 0.01) but had similar specificity (p =1.0). WBR processing did not alter sensitivity, specificity, or AUC obtained at 5 min-per-view. Overall agreement in final assessment between 5-min-per-view and 10-min-per-view acquisition types was near perfect (κ = 0.82 to 0.89); however, fair to moderate agreement was observed for assessment category 3 (probably benign) (κ = 0.24 to 0.48). Of 33 malignant lesions, 6 (18%) were changed from assessment of 4 or 5 with 10-min-per-view MBI to assessment of 3 with 5-min-per-view MBI. Image quality of 5-min-per-view studies was reduced compared to 10-min-per-view studies for both readers (3.24 vs. 3.98, p < 0.0001 and 3.60 vs. 3.91, p < 0.0001).WBR processing improved image quality for one reader (3.85 vs. 3.24, p < 0.0001).Conclusions Although similar radiologic interpretations were obtained with 10-min-and 5-min-per-view DC-MBI, resulting in substantial agreement in final assessment, notable exceptions were found: (1) perceived image quality at 5 min-per-view was lower than that for 10-min-perview studies and (2) in a number of cases, assessment was downgraded from a recommendation of biopsy to that of short interval follow-up.

AB - Background In an effort to reduce necessary acquisition time to perform molecular breast imaging (MBI), we compared diagnostic performance of MBI performed with standard 10-min-per-view acquisitions and half-time 5-min-per-view acquisitions, with and without wide beam reconstruction (WBR) processing. Methods Eighty-two bilateral, two-view MBI studies were reviewed. Studies were performed with 300 MBq Tc-99 m sestamibi and a direct conversion molecular breast imaging (DC-MBI) system. Acquisitions were 10 min-per-view; the first half of each was extracted to create 5-min-perview datasets, and WBR processing was applied. The 10-min-,5-min-,and 5-min-per-view WBR studies were independently interpreted in a randomized, blinded fashion by two radiologists. Assessments of 1 to 5 were assigned; 4 and 5 were considered test positive. Background parenchymal uptake, lesion type, distribution of non-mass lesions, lesion intensity, and image quality were described. Results Considering detection of all malignant and benign lesions, 5 min-per-view MBI had lower sensitivity (mean of 70%vs.85% (p ≤ 0.04) for two readers) and lower area under curve (AUC) (mean of 92.7 vs. 99.6, p ≤ 0.01) but had similar specificity (p =1.0). WBR processing did not alter sensitivity, specificity, or AUC obtained at 5 min-per-view. Overall agreement in final assessment between 5-min-per-view and 10-min-per-view acquisition types was near perfect (κ = 0.82 to 0.89); however, fair to moderate agreement was observed for assessment category 3 (probably benign) (κ = 0.24 to 0.48). Of 33 malignant lesions, 6 (18%) were changed from assessment of 4 or 5 with 10-min-per-view MBI to assessment of 3 with 5-min-per-view MBI. Image quality of 5-min-per-view studies was reduced compared to 10-min-per-view studies for both readers (3.24 vs. 3.98, p < 0.0001 and 3.60 vs. 3.91, p < 0.0001).WBR processing improved image quality for one reader (3.85 vs. 3.24, p < 0.0001).Conclusions Although similar radiologic interpretations were obtained with 10-min-and 5-min-per-view DC-MBI, resulting in substantial agreement in final assessment, notable exceptions were found: (1) perceived image quality at 5 min-per-view was lower than that for 10-min-perview studies and (2) in a number of cases, assessment was downgraded from a recommendation of biopsy to that of short interval follow-up.

KW - Breast cancer

KW - CZT

KW - Direct conversion

KW - Dose reduction

KW - Molecular breast imaging

KW - Wide beam reconstruction

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