BSGI Posts Higher Sensitivity than Mammography or MRI for the Detection of Ductal Carcino... (ncer detects the majority of clinically ...)

BSGI Posts Higher Sensitivity than Mammography or MRI for the Detection of Ductal Carcinoma In Situ

Date:8/19/2007

ncer, detects the majority of clinically occult DCIS as microcalicifications, the hallmark mammographic finding of DCIS. Yet, the diagnosis of DCIS remains difficult as mammography is unreliable in predicting the histology and extent of DCIS.

Breast MRI has been shown to have a sensitivity of 73-89 percent for DCIS, but a limited specificity (58-89 percent) and variable positive predictive value (25-84 percent). As with mammography, small foci of DCIS are difficult to detect on MRI, particularly lesions less than 5 mm.

"In addition, MRI may overestimate DCIS extent in as many as 50 percent of cases and often cannot distinguish benign from malignant lesions, high-grade from low-grade DCIS, or detect an invasive component concurrent with the DCIS," added Dr. Brem. "As a result, MRI remains a secondary study with limitations in DCIS detection and evaluation."

Study Methods & Materials

In the retrospective study, 20 women with 22 biopsy-proven DCIS lesions were reviewed. Patients had BSGI with the Dilon 6800, a high-resolution, small-field-of-view gamma camera in craniocaudal and mediolateral oblique projections. Image findings were compared to findings at biopsy or surgical excision. MRI was performed with a GE 1.5-T system using a dedicated breast coil. The sensitivity of BSGI, mammography, and when performed, MRI were determined for the detection of DCIS. The sensitivities were compared using a two-tailed "t" test and confidence intervals were determined.

BSGI versus MRI

The findings indicate that the pathologic tumor size of the DCIS ranged from 2-21 mm. Of the 22 cases of biopsy proven DCIS in 20 women, 91 percent were detected with BSGI, 82 percent were detected with mammography, and 88 percent were detected with magnetic resonance imaging. BSGI had the highest sensitivity for the detection of DCIS, although this small sample size did not demonstrate a statistically significant difference. Two cases of DCIS (9 percent) were diag
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SOURCE Dilon Technologies

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