Breast-Specific Gamma Imaging/Molecular Breast Imaging (BSGI/MBI) is gaining momentum as a standard of care in the diagnostic work up of patients. More than ten BSGI/MBI educational exhibits will be presented at the 2010 Radiological Society of North America (RSNA) annual meeting in Chicago next week. These upcoming presentations, along with others at radiology, surgical, and breast disease medical society meetings all around the world, continue to demonstrate the viability of the technology as an important diagnostic tool for early breast cancer detection. In addition, the Society of Nuclear Medicine (SNM) recently released a nuclear medicine breast imaging protocol that includes specific procedural guidelines and clinical indications for conducting BSGI/MBI.
More about BSGI/MBI
BSGI/MBI is especially useful in difficult-to-diagnose cases such as Ductal Carcinoma in Situ (DCIS), where mammography may not accurately display the extent of the disease, as demonstrated by one of the RSNA exhibits by researchers from the George Washington University Medical Center in Washington, D.C.
The authors used BSGI/MBI to detect DCIS lesions (ranging from 1 mm to several centimeters), to determine the extent of disease and varying pathological parameters. At the RSNA they will demonstrate the sensitivity of BSGI for DCIS to be 93 percent to 95 percent.
“BSGI is a valuable tool that improves diagnostic accuracy, and complements other modalities, when included in the breast imaging protocol,” said Jocelyn A. Rapelyea, M.D., associate professor of radiology, George Washington University. “This modality is especially effective in assessing the extent of disease and assisting in surgical planning.”
BSGI, mammography, and ultrasound
Another study that will be presented at the RSNA by investigators from Weinstein Imaging in Pittsburgh compares BSGI to mammography and ultrasound in patients undergoing diagnostic evaluation. The investigators demonstrate that BSGI is a useful tool for improving the detection of malignancies and note that the physiological information of BSGI is complementary to the anatomical depiction of the breast by mammography and ultrasound.
In June 2010 the SNM released a nuclear medicine breast imaging protocol, referred to as: The SNM Procedure Guideline for Breast Scintigraphy with Breast-Specific Gamma Cameras. This protocol includes specific guidelines for conducting BSGI and helps improve the understanding of how and when to use molecular breast imaging in patient care
As a follow-up to mammography, BSGI utilizes Dilon Technologies‘ 6800 Gamma Camera to help physicians differentiate benign from malignant tissue. To perform BSGI, the patient receives a pharmaceutical tracing agent that is absorbed by all the cells in the body. Due to their increased rate of metabolic activity, cancerous cells in the breast absorb a greater amount of the tracing agent than normal, healthy cells and generally appear as dark spots on the BSGI image.
The following educational exhibits and courses regarding BSGI/MBI are only a few of the presentations that will be delivered at the 2010 RSNA in Chicago.
Ductal Carcinoma in Situ: Imaging with Breast-Specific Gamma Imaging (BSGI)
This educational exhibit will show that mammography cannot always determine the extent of DCIS; and BSGI is an integral component to assessing the extent of disease and assisting in surgical planning.
Presented by Jocelyn A. Rapelyea, M.D., Jessica Torrente, M.D., Rachel Frydman Brem, M.D., and Allison Yingling, M.D.
Breast-Specific Gamma Imaging (BSGI) Compared to Mammography and Ultrasound in Patients Undergoing Diagnostic Breast Examinations
This educational exhibit demonstrates that BSGI is a molecular breast imaging technique that provides physiological information complementary to the anatomic depiction provided by mammography and ultrasound.
Presented by B.H. Ward, M.D., M. Bohm-Velez, M.D., Mr. R. Straka, M.D., and T.S. Chang, M.D.
Invasive Breast Cancer: Spectrum of Appearances with Breast-Specific Gamma Imaging (BSGI)
This educational exhibit demonstrates the superior sensitivity of BSGI in regard to the range of grades and sizes of invasive cancers that are detectable with BSGI that may not be visible with other modalities.
Presented by Jessica Torrente, M.D., Allison Yingling, M.D., Jocelyn A. Rapelyea, M.D., and Rachel Frydman Brem, M.D.
Comparison of Breast-Specific Gamma Imaging (BSGI) and Breast Magnetic Resonance Imaging (MRI): A Spectrum of Findings in Both Benign and Malignant Lesions
This education exhibit supports the accuracy of correlating image findings between BSGI and MRI. The direct comparison of MRI and BSGI was conducted in one patient for a variety of benign and malignant breast lesions.
Presented by Jessica Torrente, M.D., Rachel Frydman Brem, M.D., Jocelyn A. Rapelyea, M.D., and Chirag R. Parghi, M.D.
Molecular Breast Imaging for Breast Cancer Screening in Women with Mammographically Dense Breasts: Proof of Concept
This multisession course demonstrates the effectiveness of MBI as a complementary screening tool with mammography for women with dense breasts. MBI is also less likely to prompt unnecessary work-up.
Presented by D.J. Rhodes, M.D., C.B. Hruska, Ph.D., S.W. Phillips, M.D., D.H. Whaley, M.D., and M.K. O’Connor, Ph.D.