Breast-Specific Gamma Imaging: An Added Value in the Diagnosis of Breast Cancer, a Systematic Review

SIMPLE SUMMARY: Breast-specific gamma imaging represents an emergent instrument for breast cancer detection. We selected on Medline articles published from 1995 to 2022 that compare various imaging modalities with breast-specific gamma imaging. The aim of this paper was to assess if this imaging method is a more valuable choice in detecting breast malignant lesions compared to morphological counterparts such mammography, ultrasound, and magnetic resonance imaging in terms of specificity, sensibility and positive and negative predictive value. At the cost of a major radiology burden, breast-specific gamma imaging is more specific, with a sensibility comparable to magnetic resonance imaging and higher than ultrasonography and mammography. ABSTRACT: Purpose: Breast cancer is the most common solid tumor and the second highest cause of death in the United States. Detection and diagnosis of breast tumors includes various imaging modalities, such as mammography (MMG), ultrasound (US), and contrast-enhancement MRI. Breast-specific gamma imaging (BSGI) is an emerging tool, whereas morphological imaging has the disadvantage of a higher absorbed dose. Our aim was to assess if this imaging method is a more valuable choice in detecting breast malignant lesions compared to morphological counterparts. Methods: research on Medline from 1995 to June 2022 was conducted. Studies that compared at least one anatomical imaging modality with BSGI were screened and assessed through QUADAS2 for risk of bias and applicability concerns assessment. Sensitivity, specificity, positive and negative predictive value (PPV and NPV) were reported. Results: A total of 15 studies compared BSGI with MMG, US, and MRI. BSGI sensitivity was similar to MRI, but specificity was higher. Specificity was always higher than MMG and US. BSGI had higher PPV and NPV. When used for the evaluation of a suspected breast lesion, the overall sensitivity was better than the examined overall sensitivity when BSGI was excluded. Risk of bias and applicability concerns domain showed mainly low risk of bias. Conclusion: BSGI is a valuable imaging modality with similar sensitivity to MRI but higher specificity, although at the cost of higher radiation burden.