Background parenchymal uptake on molecular breast imaging as a breast cancer risk factor: a case-control study

Hruska, Carrie B.; Scott, Christopher G.; Conners, Amy Lynn; Whaley, Dana H.; Rhodes, Deborah J.; Carter, Rickey E.; O’Connor, Michael K.; Hunt, Katie N.; Brandt, Kathleen R.; Vachon, Celine M.

doi:10.1186/s13058-016-0704-6

Cited by 20 publications

(18 citation statements)

References 38 publications

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“…Also similar to MD, moderate or marked BPE, in the absence of malignancy, has been associated in several studies with an increase in BC risk ( [4,31,55], detailed in Table 4). The target populations in these studies varied, however a major theme was a MRI scan of normal breast tissue, with approximately 1-year follow-up.…”

Section: Bpe As a Complementary Bc Risk Indicatormentioning

confidence: 70%

Looking beyond the mammogram to assess mammographic density: A narrative review

Hugo

Tourell

O’Gorman

et al. 2018

BSI

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MD-the white areas on a mammogram (also known as breast density), has long been recognised as an indicator of breast cancer (BC) risk and mammographic masking. Recent legislation in 32 American states has mandated the inclusion of mammography density information in reports for women in the higher two MD quartiles, and it is a growing consideration worldwide. While the mammogram is currently the only means of estimating MD, it suffers from a number of limitations. These are related to the accumulation of low dose ionising radiation used in mammography that limits its repeated use, particularly in young women, women with previous radiation exposure, those having undergone prior surgery, or those with radio-sensitising gene mutations. This review compares and contrasts the variety of emerging technologies that can provide a quantitative and true volumetric analysis of breast density, without the use of ionising radiation.

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Section: Bpe As a Complementary Bc Risk Indicatormentioning

confidence: 70%

Looking beyond the mammogram to assess mammographic density: A narrative review

Hugo

Tourell

O’Gorman

et al. 2018

BSI

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“…Because the initial guesses and phantoms are fairly similar, the first few iterations yield the lowest error. Background parenchymal uptake of sestamibi yields non-uniform structure in breast projections [49], which may require additional OSEM iterations to resolve. A consequence of more OSEM iterations would be further reductions in SNR, but with a potential increase in contrast as observe in generated parametric curves 4 and 11.…”

Section: Discussionmentioning

confidence: 99%

Molecular Breast Imaging Using Synthetic Projections From High-Purity Germanium Detectors: A Simulation Study

Campbell

Peterson

2017

IEEE Trans. Radiat. Plasma Med. Sci.

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High-Purity Germanium (HPGe) gamma cameras are an emerging technology for Molecular Breast Imaging (MBI) due to their 2D lateral spatial resolution, depth-of-interaction (DOI) estimation, and superb energy resolution. In this simulation study, we investigate the potential imaging performance of an opposing view dual-head HPGe breast imaging system using a synthetic-projection technique, which utilizes DOI data with varying degrees of overlap in an iterative OSEM reconstruction algorithm to create 3D images from which new 2D projections are then created. The radiation transport simulator Monte Carlo N-Particle was employed to generate projections from 10-mm thick HPGe detectors using tungsten parallel-hole collimators with short and wide holes. Simulations modeling 140-keV emissions from various contrast-detail and breast-torso phantoms were conducted. Synthetic projections were generated along with conjugate-counting images from collected HPGe projections. Tumor contrast, SNR, and hot-spot detection measurements were used to compare images. Results show that the synthetic projections could resolve more low-contrast tumors compared to single-camera projections and conjugate-counting methods. MBI simulations also showed increased contrast and SNR in synthetic projections compared to individual projections. In conclusion, the HPGe imaging system employing a synthetic-projection technique may offer advantages over individual dual-camera projections or conjugate-counting methods in terms of contrast, SNR, and tumor detectability.

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“…This retrospective analysis was compliant with the US Health Insurance Portability and Accountability Act and approved by the Mayo Clinic Institutional Review Board, which issued a waiver of informed consent. A case-control study previously established to evaluate the association of subjective BPU categories with breast cancer risk was used in the current analysis [ 10 ]. As previously described, we established this case-control group within a cohort of patients who underwent MBI between 1 February 2005 and 28 February 2014 ( n = 3202) and who were followed for breast cancer diagnoses through 31 December 2014.…”

Section: Methodsmentioning

confidence: 99%

“…MBI examinations were performed as previously described [ 10 ]. Briefly, MBI was performed using a dedicated dual-head gamma camera system equipped with semiconductor-based detectors (cadmium zinc telluride).…”

Section: Methodsmentioning

confidence: 99%

“…1 . Importantly, subjective categories of high BPU were found to be associated with risk of incident breast cancer relative to those with low BPU in a case-control analysis (odds ratio (OR) range from 3 to 5) after adjustment for mammographic density and exogenous hormone use [ 10 ]. These results suggest that BPU is a functional imaging biomarker that depicts risk-related aspects of fibroglandular tissue not observed through measures of mammographic density alone.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative background parenchymal uptake on molecular breast imaging and breast cancer risk: a case-control study

et al. 2018

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BackgroundBackground parenchymal uptake (BPU), which refers to the level of Tc-99m sestamibi uptake within normal fibroglandular tissue on molecular breast imaging (MBI), has been identified as a breast cancer risk factor, independent of mammographic density. Prior analyses have used subjective categories to describe BPU. We evaluate a new quantitative method for assessing BPU by testing its reproducibility, comparing quantitative results with previously established subjective BPU categories, and determining the association of quantitative BPU with breast cancer risk.MethodsTwo nonradiologist operators independently performed region-of-interest analysis on MBI images viewed in conjunction with corresponding digital mammograms. Quantitative BPU was defined as a unitless ratio of the average pixel intensity (counts/pixel) within the fibroglandular tissue versus the average pixel intensity in fat. Operator agreement and the correlation of quantitative BPU measures with subjective BPU categories assessed by expert radiologists were determined. Percent density on mammograms was estimated using Cumulus. The association of quantitative BPU with breast cancer (per one unit BPU) was examined within an established case-control study of 62 incident breast cancer cases and 177 matched controls.ResultsQuantitative BPU ranged from 0.4 to 3.2 across all subjects and was on average higher in cases compared to controls (1.4 versus 1.2, p < 0.007 for both operators). Quantitative BPU was strongly correlated with subjective BPU categories (Spearman’s r = 0.59 to 0.69, p < 0.0001, for each paired combination of two operators and two radiologists). Interoperator and intraoperator agreement in the quantitative BPU measure, assessed by intraclass correlation, was 0.92 and 0.98, respectively. Quantitative BPU measures showed either no correlation or weak negative correlation with mammographic percent density. In a model adjusted for body mass index and percent density, higher quantitative BPU was associated with increased risk of breast cancer for both operators (OR = 4.0, 95% confidence interval (CI) 1.6–10.1, and 2.4, 95% CI 1.2–4.7).ConclusionQuantitative measurement of BPU, defined as the ratio of average counts in fibroglandular tissue relative to that in fat, can be reliably performed by nonradiologist operators with a simple region-of-interest analysis tool. Similar to results obtained with subjective BPU categories, quantitative BPU is a functional imaging biomarker of breast cancer risk, independent of mammographic density and hormonal factors.Electronic supplementary materialThe online version of this article (10.1186/s13058-018-0973-3) contains supplementary material, which is available to authorized users.

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Background parenchymal uptake on molecular breast imaging as a breast cancer risk factor: a case-control study

Cited by 20 publications

References 38 publications

Looking beyond the mammogram to assess mammographic density: A narrative review

Looking beyond the mammogram to assess mammographic density: A narrative review

Molecular Breast Imaging Using Synthetic Projections From High-Purity Germanium Detectors: A Simulation Study

Quantitative background parenchymal uptake on molecular breast imaging and breast cancer risk: a case-control study

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