Diagnostic Efficacy of Technetium-۹۹m-Sestamibi Scintimammography in Comparison with Mammography toDetect Breast Lesions: A Systematic Review

Background: To systematically review the performance of scintimammographycompared with mammography in detecting breast lesions.Methods: A literature search was performed in PubMed and ScienceDirectdatabases with “scintimammography AND breast lesions,” “mammography ANDbreast lesions,” “diagnostic value,” and “accuracy” as keywords to identify allrelated studies published in English from January ۱, ۲۰۰۰, to August ۱, ۲۰۱۷.Twenty-five studies, with a total of ۴۰۹۴ patients with clinically suspicious breastlesions, were included in the final analysis to assess the sensitivity, specificity,positive predictive value (PPV), and negative predictive value (NPV) ofscintimammography vs. mammography in detecting breast lesions.Results: The sensitivity and specificity of mammography were ۷۵.۸۲ ± ۱۰.۵۳(۹۵% confidence interval [CI], ۵۰-۸۴) and ۵۹.۵۸ ± ۲۲.۷۹ (۹۵% CI, ۲۰-۹۱.۴),respectively. The PPV and NPV of mammography were ۷۵.۶۰ ± ۲.۲۱ (۹۵% CI, ۴۲-۹۳) and ۶۱.۶۲ ± ۱.۶۷ (۹۵% CI, ۳۹.۱-۸۶), respectively. The sensitivity ofscintimammography was ۸۶.۶۴ ± ۸.۸۴ (۹۵% CI, ۵۸.۳-۱۰۰), and the specificity was۸۳.۴۲ ± ۱۰.۷۴ (۹۵% CI, ۶۰-۱۰۰). The PPV and NPV of scintimammography were۸۲.۱۰ ± ۱۱.۶۵ (۹۵% CI, ۵۸-۹۸.۳۰) and ۸۱.۰۲ ± ۱۷.۰۰ (۹۵% CI, ۴۵-۱۰۰), respectively.Conclusions: Although mammography has a high sensitivity in theexamination of older patients with fatty breast tissue, it is less reliable in detectingbreast lesions in young and premenopausal patients with dense breasts. Diagnosticaccuracy of scintimammography, as a functional imaging modality, is not affectedby breast density, contrary to mammography. Therefore, scintimammography canimprove the specificity of mammography.

Keywords:

Technetium-۹۹m-sestamibi , scintimammography , mammography , breast Lesions