ROLE OF TC-99M SESTAMIBI SCINTIMAMMOGRAPHY AND CONTRAST-ENHANCED MAGNETIC-RESONANCE-IMAGING FOR THE EVALUATION OF INDETERMINATE MAMMOGRAMS

This study evaluated and compared technetium-99m sestamibi scintimammo graphy (SMM) and breast magnetic resonance imaging (MRI) results in pa tients with indeterminate mammograms to determine whether either techn ique can improve the sensitivity and specificity for the diagnosis of breast carcinoma. From 123 consecutive patients who underwent physical examination, mammography, SMM, and histopathologic confirmation, a su bgroup of 82 patients presenting with indeterminate mammograms was stu died. Sixty-eight patients underwent contrast-enhanced MRI. SMM result s were scored on the basis of the intensity and pattern of sestamibi u ptake. MRI images were scored on the basis of signal intensity increas e after administration of contrast material as well as the enhancement pattern and speed of gadolinium uptake, The results obtained with the two techniques were compared and related to the final histopathologic diagnoses, Considering indeterminate findings as positive, the sensit ivity of SMM was 79% and the specificity, 70%, MRI displayed a sensiti vity of 84% and a specificity of 49%, When indeterminate results were considered negative, the sensitivity and specificity of SMM were 62% a nd 83%, respectively, MRI revealed a sensitivity and specificity of 56 % and 79%, respectively, The calculated sensitivities and specificitie s demonstrate the diagnostic limitations of both SMM and MRI in the ev aluation of patients with indeterminate mammographic findings, Due to the higher specificity, SMM may be the preferred modality in the evalu ation of selected patients with breast abnormalities.