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

Background: Background 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 ca...

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Publicado en:Breast Cancer Research Vol. 20; no. 1
Autores principales: Hruska, Carrie B., Geske, Jennifer R., Swanson, Tiffinee N., Mammel, Alyssa N., Lake, David S., Manduca, Armando, Conners, Amy Lynn, Whaley, Dana H., Scott, Christopher G., Carter, Rickey E., Rhodes, Deborah J., O'Connor, Michael K., Vachon, Celine M.
Formato: research Journal Article
Publicado: BioMed Central 6/5/2018
Acceso en línea:Ver este registro en EBSCOhost
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        14655411
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      dt: 6/5/2018
      vid: 20
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      pid: 24147
      pub: BioMed Central
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        10.1186/s13058-018-0973-3
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        atl: Quantitative background parenchymal uptake on molecular breast imaging and breast cancer risk: a case-control study.
      aug:
        au:
          Hruska, Carrie B.
          Geske, Jennifer R.
          Swanson, Tiffinee N.
          Mammel, Alyssa N.
          Lake, David S.
          Manduca, Armando
          Conners, Amy Lynn
          Whaley, Dana H.
          Scott, Christopher G.
          Carter, Rickey E.
          Rhodes, Deborah J.
          O'Connor, Michael K.
          Vachon, Celine M.
        affil: Department of Physiology and Biomedical Engineering Mayo Clinic 200 First Street SW 55905 Rochester MN USA
      sug:
        subj:
          Breast Neoplasms
          Breast
          Molecular Imaging
          Breast Pathology
          Human
          Middle Age
          Risk Factors
          Aged, 80 and Over
          Case Control Studies
          Breast Neoplasms Pathology
          Female
          Mammography Methods
          Adult
          Aged
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Clinical Assessment Tools
          Middle Aged: 45-64 years
          Aged, 80 & over
          Adult: 19-44 years
          Aged: 65+ years
          Female
      ab: Background: Background 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.Methods: Two 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.Results: Quantitative 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).Conclusion: Quantitative 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.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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