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Gamma imaging picks up cancer unseen by mammograms

By Kristin Minogue | December 3, 2008

Out of every 10 women whose mammogram or physical exam reveals potentially cancerous cells in their breasts, approximately three of them will have additional dangerous clusters the examinations missed, according to a recent study presented at the RSNA conference Wednesday.

Breast-specific gamma imaging can detect cancer cells that escape the notice of mammograms and physical exams, said lead author Dr. Rachel Brem, a professor of radiology at The George Washington University Medical Center in Washington, DC.

The danger is even greater for women who have dense breasts that can mask the presence of cancer, a category that encompasses more than half of women under 50, Brem said.

Brem's team of researchers examined the records 159 women who underwent breast-specific gamma-imaging after their mammograms or clinical exams revealed one or more suspicious or cancerous lesions. Gamma imaging revealed at least one more suspicious lesion in 29% of them.

The technique uses a different approach from traditional mammograms.

"They're anatomic approaches to breast cancer detection. They ask, what does breast cancer look like?" Brem said. "But what if you could fundamentally look at breast cancer from a different perspective? What if you could say, ‘how does breast cancer function differently from the normal surrounding breast tissue?'"

To detect potentially dangerous cells using gamma imaging, the physician injects technetium-99m-sestamibi into the patient's arm. Cancer cells, due to their high metabolic activity, absorb much more of the substance than normal cells. This sends up a red flag for doctors looking for signs of danger.

At least half the occult cancers detected in this study were smaller than 1 cm, but Brem said gamma imaging can detect early lumps as small as 1 mm.

Although this radiotracer has been used for over 10 years, Brem said its ability to unearth additional cancers could affect how women receive treatment.

She also said it could be particularly helpful for patients with diabetes, a disease that can pose problems for the positron emission mammography (PEM). But she warned that gamma imaging should not be seen as a replacement for mammograms.

"This will not obviate the need for either mammography or tomosynthesis," she said, referring to an x-ray technique also used to detect breast cancer.

Brem estimated the equipment costs approximately $250,000, and the radiotracer roughly $75. More than 80,000 patients in the U.S. have used BSGI to date, according to Brem.

 

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RSNA 2008 December 3

High coronary calcium scores up the risk of coronary events
December 3, 2009

Adding coronary calcium to the assessment of conventional cardiovascular risk factors leads to substantial improvement in cardiovascular risk classification of asymptomatic men and women, according to a study presented at the RSNA on Wednesday afternoon.

Mammo image enhancer aims for OEMs at RSNA 2009
December 3, 2009

RSNA newbie Real-Time Tomography launched at this year’s meeting a new image processing and enhancement software library for digital mammography.

Gamma imaging picks up cancer unseen by mammograms
December 3, 2008

Out of every 10 women whose mammogram or physical exam reveals potentially cancerous cells in their breasts, approximately three of them will have additional dangerous clusters the examinations missed, according to a recent study presented at the RSNA conference Wednesday.

Radiologists identify new self-embedding disorder plaguing teens
December 3, 2008

A new kind of self-mutilation is creeping into the teenage population, one that involves inserting objects into the body, according to radiologist Dr. William E. Shiels, II, who presented the first study of the adolescent phenomenon at the RSNA conference Wednesday.

Robotic therapy expands recovery window for stroke patients
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With the help of new robotic training, victims of stroke may be able to extend the narrow six-month window to regain their mobility, according to a recent study presented at the RSNA conference Wednesday.

Breast-specific gamma imaging shows better sensitivity than other methods
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Breast-specific gamma imaging demonstrates better specificity and sensitivity than mammography, ultrasound, and MRI, according to several studies presented at the RSNA meeting.

Studies attest to prognostic value of coronary CTA
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In response to demands for evidence that cardiac CT will positively affect patient outcomes, researchers presented results at the RSNA conference Wednesday attesting to its value for identifying which intermediate risk patients are most likely to suffer future catastrophic coronary events.

CT bests ultrasound for diagnosing ER patients with abdominal pain
December 3, 2008

The news was mixed for CT in the emergency department in research presented Wednesday at the RSNA meeting. CT was found to be better than ultrasound for diagnosing ER patients with abdominal pain, but radiation dose can be drastically reduced for patients suspected of appendicitis, according to authors of several studies.

Single fast MR sequence for knee osteoarthritis captures imagination of MSK rads
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A new 3D, fast spin-echo MR sequence at 3T could one day help musculoskeletal radiologists perform a comprehensive evaluation of articular cartilage of the knee in only five minutes, according to researchers from Wisconsin and California.

Imaging utilization rises where radiology presence drops
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Rates of diagnostic imaging utilization varied by more than 56% across the 10 Medicare regions of the U.S., according to a study presented Wednesday. The regions with the highest utilization had the lowest percentage of imaging services provided by radiologists.

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