Half-time Tc-99m sestamibi imaging with a direct conversion molecular breast imaging system

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Molecular breast imaging (MBI) is crucial for detecting breast cancer.
• Acquisition time is a limiting factor in MBI procedures.
• Optimizing MBI protocols can improve patient throughput and accessibility.

Purpose of the Study:

• To compare the diagnostic performance of standard 10-minute per view MBI with half-time 5-minute per view MBI.
• To evaluate the impact of wide beam reconstruction (WBR) processing on 5-minute MBI studies.
• To assess changes in image quality and radiologist interpretation between acquisition protocols.

Main Methods:

• Eighty-two bilateral, two-view direct conversion MBI (DC-MBI) studies using Tc-99m sestamibi were analyzed.
• Standard 10-minute per view datasets were compared with 5-minute per view datasets, with and without WBR processing.
• Two radiologists independently interpreted studies in a blinded, randomized manner, assigning assessments from 1 to 5.

Main Results:

• 5-minute per view MBI showed lower sensitivity (70% vs. 85%) and AUC (92.7 vs. 99.6) compared to 10-minute per view MBI.
• WBR processing did not significantly alter sensitivity, specificity, or AUC for 5-minute MBI.
• Image quality was reduced in 5-minute studies, and fair to moderate agreement was noted for assessment category 3 (probably benign).
• 18% of malignant lesions were downgraded from biopsy recommendation to short-interval follow-up on 5-minute MBI.

Conclusions:

• While 5-minute per view DC-MBI offers substantial agreement in final assessment, it results in lower perceived image quality.
• A notable number of cases showed a downgrade in assessment from biopsy recommendation to short-interval follow-up with reduced acquisition time.
• WBR processing did not compensate for the diagnostic performance or image quality reduction associated with 5-minute MBI acquisition.