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Breast-Specific -Imaging: Molecular Imaging of the Breast Using ^99mTc-Sestamibi and a Small-Field-of-View -Camera^*

Cancer Services, Department of Nuclear Medicine, Legacy Good Samaritan Hospital, Portland, Oregon; and Good Samaritan Breast Health Center, Portland, Oregon

Correspondence: For correspondence or reprints contact: Elizabeth A. Jones, Legacy Good Samaritan Hospital, Department of Nuclear Medicine, 1015 NW 22nd Ave., Portland, OR 97210. E-mail: eljones{at}lhs.org

ABSTRACT

Breast-specific -imaging (BSGI), also known as molecular breast imaging, is breast scintigraphy using a small-field-of-view -camera and ^99mTc-sestamibi. There are many different types of breast cancer, and many have characteristics making them challenging to detect by mammography and ultrasound. BSGI is a cost-effective, highly sensitive and specific technique that complements other imaging modalities currently being used to identify malignant lesions in the breast. Using the current Society of Nuclear Medicine guidelines for breast scintigraphy, Legacy Good Samaritan Hospital began conducting BSGI, breast scintigraphy with a breast-optimized -camera. In our experience, optimal imaging has been conducted in the Breast Center by a nuclear medicine technologist. In addition, the breast radiologists read the BSGI images in correlation with the mammograms, ultrasounds, and other imaging studies performed. By modifying the current Society of Nuclear Medicine protocol to adapt it to the practice of breast scintigraphy with these new systems and by providing image interpretation in conjunction with the other breast imaging studies, our center has found BSGI to be a valuable adjunctive procedure in the diagnosis of breast cancer. The development of a small-field-of-view -camera, designed to optimize breast imaging, has resulted in improved detection capabilities, particularly for lesions less than 1 cm. Our experience with this procedure has proven to aid in the clinical work-up of many of our breast patients. After reading this article, the reader should understand the history of breast scintigraphy, the pharmaceutical used, patient preparation and positioning, imaging protocol guidelines, clinical indications, and the role of breast scintigraphy in breast cancer diagnosis.

Key Words: breast-specific gamma imaging (BSGI); molecular breast imaging (MBI); mammography; ultrasound; scintimammography; breast scintigraphy