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The Use of Breast-specific Gamma Imaging as a Low-Cost Problem-Solving Strategy for Avoiding Biopsies in Patients With Inconclusive Imaging Findings on Mammography and Ultrasonography.

Authors :
Ko, Andrew
Vo, Alexander M
Miller, Nathaniel
Liang, Annie
Baumbach, Maia
Argue, Jay Riley
Manche, Nathaniel
Gonzalez, Luis
Austin, Nicholas
Carver, Philip
Procell, Joseph
Elzein, Hassan
Pan, Margaret
Zeidan, Nadine
Kasper, William
Speer, Samuel
Liang, Yizhi
Pettus, Benjamin J
Source :
Journal of Breast Imaging; Sep/Oct2024, Vol. 6 Issue 5, p502-512, 11p
Publication Year :
2024

Abstract

Objective To evaluate the clinical performance and financial costs of breast-specific gamma imaging (BSGI) as a biopsy-reducing problem-solving strategy in patients with inconclusive diagnostic imaging findings. Methods A retrospective analysis of all patients for whom BSGI was utilized for inconclusive imaging findings following complete diagnostic mammographic and sonographic evaluation between January 2013 and December 2018 was performed. Positive BSGI findings were correlated and biopsied with either US or stereotactic technique with confirmation by clip location and pathology. After a negative BSGI result, patients were followed for a minimum of 24 months or considered lost to follow-up and excluded (22 patients). Results of further imaging studies, biopsies, and pathology results were analyzed. Net savings of avoided biopsies were calculated based on average Medicare charges. Results Four hundred and forty female patients from 30 to 95 years (mean 55 years) of age were included in our study. BSGI demonstrated a negative predictive value (NPV) of 98.4% (314/319) and a positive predictive value for biopsy of 35.5% (43/121). The overall sensitivity was 89.6% (43/48), and the specificity was 80.1% (314/392). In total, 78 false positive but only 5 false negative BSGI findings were identified. Six hundred and twenty-one inconclusive imaging findings were analyzed with BSGI and a total of 309 biopsies were avoided. Estimated net financial savings from avoided biopsies were $646 897. Conclusion In the management of patients with inconclusive imaging findings on mammography or ultrasonography, BSGI is a problem-solving imaging modality with high NPV that helps avoid costs of image-guided biopsies. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
26316110
Volume :
6
Issue :
5
Database :
Complementary Index
Journal :
Journal of Breast Imaging
Publication Type :
Academic Journal
Accession number :
180267056
Full Text :
https://doi.org/10.1093/jbi/wbae040