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Mayo: Molecular Imaging For Dense Breasts

June 12, 2012
Written by: , Filed in: Breast Imaging
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Molecular breast imaging (MBI) can be an effective alternative to mammography as a breast cancer screening tool for women with dense breasts, according to a presenter at this week’s SNM 2012 Annual Meeting in Miami Beach. There is, however, one problem: radiation dosage.

(Actually, that should probably be the SNMMI 2012 Annual Meeting. The Society of Nuclear Medicine membership voted to change the organization’s name to the Society of Nuclear Medicine and Molecular Imaging.)

Michael K. O’Connor, PhD, professor of radiologic physics at Mayo Clinic in Rochester, Minnesota, said molecular breast imaging was more effective than mammography for detecting cancer in dense breasts. He mentioned a proof-of-principle study that was published in the January 2011 issue of Radiology.

The study compared MBI to mammography for women with dense breasts. “Basically, three times as many cancers were picked up,” Dr. O’Connor said, according to DOTmed News.

Mayo prefers a dual-head cadmium zinc telluride detector because, according to Dr. O’Connor, it’s more sensitive than a single-head system in detecting very small cancers. Gamma Medica and GE Healthcare currently use that technology.

A similar technology, breast specific gamma imaging, uses a single detector head. Dilon Technologies is the only company currently marketing equipment that uses it. It has the advantage of being able to guide a biopsy once a lesion is detected, unlike the Gamma Medica and GE systems.

Both technologies share a problem: comparatively high radiation doses. Said Dr. O’Connor:

We’re devoting a lot of effort to trying to reduce the dose, to at least get down to doses that are comparable to mammography.

The radiation problem affects radiologic technologists as well as patients. Technologists often stand next to the patient during the procedure. At eight patients per day, their dosages would be four times higher than technologists working in general nuclear medicine and cardiology now receive, Dr. O’Connor said.

Assuming progress on that front, which seems likely, use of molecular breast imaging and breast specific gamma imaging appears poised for a big increase.

“I think what you’ll find over the next few years as we get toward individualized medicine, the best technique for a patient will depend on a patient’s characteristics,” Dr. O’Connor said, “and all of those will probably determine where MBI fits in best.”

Related seminar: UCSF Breast Imaging and Digital Mammography

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