Experts establish guidelines for correct usage of molecular breast scan technology
In a significant development for the field of breast cancer diagnosis, a new set of appropriate use criteria for molecular breast imaging has been published in the Journal of Nuclear Medicine Technology. The criteria were developed by a workgroup of 10 experts, convened by the Society of Nuclear Medicine and Molecular Imaging (SNMMI).
The new guidelines aim to assist healthcare providers in selecting appropriate advanced imaging techniques in various clinical scenarios. Molecular breast imaging, which uses a radioactive tracer called Tc-99m sestamibi, has advanced to allow for high-resolution, low-dose imaging with dedicated breast imaging gamma camera systems.
One of the key applications of molecular breast imaging, according to the new criteria, is supplemental screening after mammography. This is particularly relevant for women with dense breasts, who are at an increased risk of breast cancer. The criteria specify that molecular breast imaging is appropriate for women with dense breasts at average or intermediate risk, as well as those at high risk.
The new guidelines also highlight the role of molecular breast imaging in managing discordant biopsy results, addressing indeterminate findings on a mammogram or ultrasound, and in initial staging and evaluation of local tumour extent in a new diagnosis of breast cancer.
Another important application of molecular breast imaging, as outlined in the criteria, is neoadjuvant therapy response monitoring. This refers to the monitoring of a patient's response to treatment before surgery. Molecular breast imaging can provide valuable information about the effectiveness of the treatment, helping to guide further treatment decisions.
In addition, the criteria suggest that molecular breast imaging-guided biopsy may be appropriate in certain cases. This would involve using molecular breast imaging to guide the placement of the biopsy needle, potentially improving the accuracy of the biopsy.
It's worth noting that mammograms with technical limitations, such as free silicone injection, prior therapy, or postradiation fibrosis, may not be suitable for all cases. However, the new guidelines provide valuable guidance on when and how these tests should be used.
The new appropriate use criteria for Tc-99m sestamibi-based gamma camera breast examinations are a significant step forward in the field of breast cancer diagnosis. The authors of the article, published on August 26 in the Journal of Nuclear Medicine Technology, are not publicly specified.
The workgroup that developed the criteria included representatives from the American College of Radiology (ACR), the American College of Nuclear Medicine (ACNM), the Society of Breast Imaging (SBI), the American Society of Breast Surgeons (ASBS), the American Society of Clinical Oncology (ASCO), and the European Association of Nuclear Medicine (EANM). This multi-disciplinary approach ensures that the guidelines are informed by a wide range of perspectives and expertise.
The new criteria also highlight the importance of supplemental screening/surveillance in patients with a history of breast cancer. This is particularly important for patients who are at a high risk of recurrence.
In conclusion, the new appropriate use criteria for Tc-99m sestamibi-based gamma camera imaging of the breast provide valuable guidance for healthcare providers. They offer a clear and concise guide to the most appropriate uses of molecular breast imaging, helping to improve the accuracy and effectiveness of breast cancer diagnosis and treatment.
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