1 –Purpose Molecular Breast Imaging (MBI) uses a new semiconductor (CZT) imaging detector in a dual-head configuration to optimize detection of small (<1.0 cm) lesions in early stage breast cancer. The technique involves the intravenous administration of the radiopharmaceutical 99mTc-sestamibi (MIBI), which is the contrast agent of choice in more than 15 M nuclear cardiology studies annually worldwide. The combination of enhanced permeability and retention in neovasculature with mitochondrial metabolism produce uptake of MIBI in breast cancer lesions that is generally greater than 10:1 compared...

2. Materials and Methods Molecular Breast Imaging MBI is the non-invasive and quantitative imaging of cellular and molecular processes of normal and malignant breast tissue – with the use of an injectable contrast agent - to aid in detection, diagnosis, and treatment assessment. CZT-based MBI Scanner Semiconductor CZT The 140 keV gamma-ray emissions from 99mTc are detected and localized by semiconductor CZT modules (Figure 1). The modules are arranged into two large (15.2 cm x 20.3 cm) plates each with a pixel array of 96x128...

Comparison of Benefit/Risk Addressing the concerns An important paper was published in 2010 by Hendrick in which wholebody radiation dose concerns were voiced about BSGI and other nuclear medicine scans breast scans such as PEM [He 10]. O’Connor’s paper [Oc 10a] helped to put these concerns in perspective by calculating benefit/risk ratios of the various screening modalities based on the BEIR VII formalism described in Section 3. With the pixel size optimized at 1.6 mm, the detection efficiency is 3.6 times greater than that which...

MBI Example: 7 mm Lesion An ongoing screening study at Mayo Clinic with MBI in a cohort of patients with radiographically dense breast has reported promising results of a factor of three improvement in detection sensitivity over mammography in this population [Rh 10]. In Sidebar Figure 1 (Figure 7) we can see an example, courtesy of Dr. Michael O’Connor of the Mayo Clinic, of a 7 mm tubulolobular carcinoma confirmed on biopsy that was called negative on the mammogram. This example demonstrates the potential of...

References Hays MT; Watson EE; Thomas SR; Stabin M. MIRD dose estimates report no. 19: radiation absorbed dose estimates from 18F-FDG. J Nucl Med 2002; 43: 210-214. Hendrick RE. Radiation doses and cancer risk from breast imaging studies. Radiology 257 (October 2010): 246-253. Law J; Faulkner K. Cancers detected and induced, and associated risk and benefit, in a breast screening program. Brit J Radiol 2001; 74: 1121-1127. NCRP Report No. 160 – Ionizing radiation exposure of the population of the United States (2009). National Council...