유방 종괴에서 악성 감별을 위한 유방촬영술과 유방스캔의 유용성 연구 (The Usefulness of Mammography and Scintimammography in Differential Diagnosis of Breast Tumor) |
Author |
강봉주.정용안.정현석.정정임.유이령.김성훈.손형선.정수교.한성태.이재문, |
Bong Joo Kang, M.D., Young An Chung, M.D., Hyun Seok Jung, M.D., Jung Im Jung, M.D.,Ie Ryung Yoo, M.D., Sung Hoon Kim, M.D., Hyung Sun Sohn, M.D., Soo Kyo Chung, M.D.,Seong Tai Hahn, M.D., Jae Mun Lee, M.D. |
Affiliation |
가톨릭의과대학 성모병원 방사선과학교실 Department of Radiology The College of Medicine, The Catholic University of Korea |
Abstract |
Purpose: It is very important to differentiate breast cancer from benign mass. There are many reports to evaluate
the differential diagnosis under the several diagnostic tools. We evaluated the usefulness of mammography and
Tc-99m MIBI scintimammography in the differential diagnosis of breast mass and correlated with pathologic findings.
Materials and Methods: This study included 80 patients (age: 24-72, mean: 48.4) who underwent mammography and
Tc-99m MIBI scintimammography for breast masses. Scintimammographies (anterior-posterior and lateral projections)
were acquired in 10 minutes and 2 hours after intravenous injection of Tc-99m MIBI. Four specialists in diagnostic
radiology and nuclear medicine evaluated the findings of breast masses under the mammography and Tc-99m MIBI
scintimammography, and calculated the tumor to background (T/B) ratio. The pathologic results were obtained and
we statistically analyzed the correlations between pathologic results and imaging findings under the mammography
and Tc-99m MIBI scintimammography by chi-square and correlation test. Results: The sensitivity, specificity, positive
predictive value, and negative predictive value of mammography for detection of breast cancer were 87.5%, 56.3%,
75.0%, and 75.0% respectively. 45 cases of 80 patients were suspicious for breast cancer under the Tc-99m MIBI
scintimammography. 41 cases of 45 patients were confirmed as breast cancer and the remaining 4 cases were
confirmed as benign masses. The sensitivity, specificity, positive predictive value and negative predictive value of
Tc-99m MIBI scintimammography for detection of breast cancer were 85.4%, 87.5%, 91.1%, and 80.8% respectively.
The sensitivity of scintimammography was lower than that of mammography for detection of breast cancer, however
the specificity, positive predictive value, and negative predictive value were higher. In the benign mass, the mean
T/B ratio in 10 minutes was 1.409¡¾0.30, and that in 2 hours was 1.267¡¾0.42. The maximal T/B ratio of benign mass
in 10 minutes was 1.604¡¾0.42, and that in 2 hours was 1.476¡¾0.50. In the malignant mass, the mean T/B ratio in
10 minutes was 2.220¡¾1.07, and that in 2 hours was 1.842¡¾0.75. The maximal T/B ratio of malignant mass was 2.993
¡¾1.94, and that in 2 hours was 2.480¡¾1.34. And the T/B ratio under the early and delayed images were meaningful.
Conclusion: The scintimammography is useful diagnostic tool to differentiate breast cancer from benign mass,
although the sensitivity of mammography for detection of breast mass is high. Especially, the use of the T/B ratio
is helpful to diagnose breast cancer.(Korean J Nucl Med 38(6):492-497, 2004) |
Keyword |
Tc-99m MIBI scintimammography, mammography, breast cancer, tumor to backgraound ratio |
Full text Article |
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