Breast-specific gamma imaging reveals unseen cancers

2008 12 04 13 33 10 647 Brem Resized

CHICAGO - A review of clinical use of breast-specific gamma imaging indicates that the function-based technology changed breast cancer treatment options because additional malignancies were pinpointed by the new modality.

"Gamma imaging can impact treatment management," said Dr. Rachel Brem, a professor of radiology and director of the Breast Imaging and Intervention Center at George Washington University Medical Center in Washington, DC, in her report to RSNA attendees on Wednesday.

"X-rays and magnetic resonance find breast lesions by looking at their shape; breast-specific gamma imaging locates these lesions by how they function," Brem said. She said that gamma imaging has potential as an adjunct to mammography or as a screening tool among high-risk patients.

2008 12 04 13 33 10 647 Brem Resized
Dr. Rachel Brem from the Breast Imaging and Intervention Center.
The study involved breast-specific gamma imaging scans performed with the Dilon 6800 gamma camera (Dilon Technologies, Newport News, VA), which detects increased accumulation of the nuclear tracer technetium sestamibi after the tracer is injected into a patient's veins.

In the study, researchers reviewed 159 scans in which doctors used gamma imaging technology following initial discovery of a tumor. Brem said that in 56 cases, gamma imaging revealed a new suspicious area. Eventually, 45 of those suspicious regions were biopsied, and 14 of those biopsies came back positive for cancer. Overall, that meant that 9% of the women had additional occult cancers, she said.

Nine of the cancers were found in the same breast as the original lesion; five were in the contralateral breast. The cancers that were detected using gamma imaging ranged in size from 0.1 cm to 3.6 cm in diameter.

Brem highlighted one case of a woman who was being considered for lumpectomy, but gamma imaging found another extensive tumor a distance from the original finding, requiring a change in management to mastectomy.

The women in the study were 19 to 93 years of age, with a mean age of 54 years. They all had been diagnosed with one biopsy-proven breast cancer. Approximately 73% of women in the study were classified as having dense breasts, a condition that makes diagnosis with traditional modalities difficult.

The study was funded by the hospital; however, Brem disclosed that she is a board member of Dilon Technologies.

In her discussion of the study, Dr. Mary Mahoney, director of breast imaging at the University of Cincinnati College of Medicine, said that "breast-specific gamma imaging is one of the growing number of molecular imaging modalities that allow us to detect ever-smaller lesions."

She said that Brem's work demonstrated that breast-specific gamma imaging was more than just a tool to find smaller and smaller cancers, in that it was able to guide therapy decisions.

By Edward Susman contributing writer
December 4, 2008

Related Reading

Dual-head gamma camera increases breast lesion detection, November 28, 2008

Molecular breast imaging offers promise as mammography adjunct, September 15, 2008

Solid-state scintimammography matches breast MRI, July 2, 2008

Breast gamma imaging spots DCIS better than mammo, MR, August 13, 2007

Solid-state dual-head camera supercharges molecular breast imaging, December 19, 2006

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