Breast-Specific Gamma Imaging (BSGI)
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BSGI

 

Breast-Specific Gamma Imaging (BSGI) is made possible by a unique camera – the Dilon 6800 Gamma Camera. This high-resolution, small field-of-view device can detect early stage cancers (as small as 3 mm), see lesions independent of tissue density, and provide multiple angle views for direct correlation to mammograms.

Functional, or nuclear breast imaging, was discovered when large gamma cameras were being used for cardiac imaging. Suspicious areas were often noted in the chest wall of women, and over time physicians began to realize the benefit of applying nuclear medicine to breast cancer diagnosis – in its early incarnation this diagnostic procedure was called "scintimammography."

Ongoing advances in gamma detector technology have led to the development of a functional breast imaging procedure, Breast-Specific Gamma Imaging (BSGI), which uses a detector optimized for high-resolution breast imaging. Having evolved from scintimammography, BSGI is also based on the enhanced uptake of Sestamibi in tumors within the breast; and BSGI with the Dilon 6800 overcomes the limitations of early scintimammography.

When post-mammogram evaluation is indicated, BSGI as a “next-step measure” is the ideal complement to mammography because of its high specificity and sensitivity for sub-centimeter lesions.

Unlike the conventional gamma camera's detector, Dilon's detector can be positioned directly against the chest wall, significantly improving spatial resolution, and rotate to obtain all possible views. The Dilon 6800 Gamma Camera also reliably detects sub-centimeter lesions, down to 3 mm, in the same views as mammography. Another major benefit of the Dilon system is its compact design and mobility, allowing for same-day evaluation and imaging at the point of care.

Radiology Indications

Using a physiological approach to breast cancer detection allows for more specific evaluations and improved management of challenging cases. Breast-Specific Gamma Imaging (BSGI) is a molecular study of the breast that provides physiological data not available from any other imaging modality and can help quickly determine the nature of suspicious lesions and, in many cases, the extent of disease.

BSGI complements mammography for patients who are difficult to diagnose, or have:

  • Dense breast tissue
  • Palpable lesions not detected by mammography or ultrasound
  • Multiple suspicious lesions or clusters of calcifications
  • Pre-biopsy evaluation of suspect areas (helps determine extent of disease)
  • Implants
  • Post-surgical or post-therapeutic mass

From a radiological perspective, BSGI with the Dilon 6800 Gamma Camera delivers the following benefits:

  • Helps evaluate the need for 6-month follow-up
  • Provides high specificity and negative predictive values ~ 92 percent and 99 percent respectively
  • Has SmartShield™ to lower scatter radiation and immobilize the breast
  • Helps evaluate the need, and localize areas of interest, for biopsy
  • Significantly aids in the differentiation of benign and malignant tissue
  • Sensitivity to smaller non-palpable and/or medially located lesions
  • Highest sensitivity for detecting DCIS and lobular carcinomas
  • Permits imaging in all mammographic views
  • When compared to MRI, BSGI is easier to interpret, has fewer patient restrictions, and a lower false positive rate

 

Surgical Indications

Using a physiological approach to breast cancer detection allows for more specific evaluations and improved management of challenging cases.  Breast-Specific Gamma Imaging (BSGI) is a molecular study of the breast that provides physiological data not available from any other imaging modality and can help quickly determine the nature of suspicious lesions and, in many cases, the extent of disease.

BSGI complements mammography for surgical patients with:

  • Radiodense breasts that are difficult to image
  • Evaluation of indeterminate or suspicious lesions identified by mammography
  • Post-surgical or post-therapeutic evaluation of mammographic tissue changes
  • Evaluation of multiple lesions or clusters of microcalcifications to aid in biopsy target selection
  • Palpable mass not demonstrated in mammogram or ultrasound
  • Lobular Carcinoma & DCIS

 

BSGI is also fundamental when:

  • Determining the extent of the primary lesion
  • Evaluating the axillary region for node status in breast cancer patients
  • Multi-focality and multicentricity
  • Monitoring primary tumor response to neoadjuvant chemotherapy

 

From a surgical perspective, BSGI with the Dilon 6800 Gamma Camera delivers the following benefits:

  • Permits imaging in all mammographic views
  • Improves management of difficult to diagnose patients
  • Helps evaluate the need for 6-month follow-up
  • Significantly aids in the differentiation of benign and malignant tissue

 

  • Sensitive to smaller non-palpable and/or medially located lesions
  • Has SmartShield™ that can lower scatter radiation and immobilize the breast
  • Helps evaluate the need, and localize areas of interest, for biopsy
  • Evaluates extent of disease for breast conservation surgery
  • When compared to MRI, BSGI is easier to interpret, has fewer patient restrictions, and a lower false positive rate

BSGI in the Diagnostic Protocol 

Because BSGI with the Dilon 6800 Gamma Camera provides high sensitivity and specificity, it is an ideal complementary diagnostic procedure to mammography. While X-ray mammograms image tissue densities, not cancer activity, BSGI with the Dilon 6800 Gamma Camera uses radiotracer uptake to detect cancer independent of tissue density.

Additionally, BSGI - as a functional procedure - images cellular activity while both MRI and ultrasound image tissue density. While certain types of breast tissue may interfere with cancer detection, functional imaging allows physicians to see the breast more clearly by accessing a map of cellular metabolism. The specificity of BSGI has also historically been higher than that of breast MRI.

About Dilon Technologies, LLC

Based on research from the Department of Energy's national laboratories, Dilon Technologies has developed innovative medical imaging technologies. Recognizing the need for early detection of breast cancer, Dilon developed the Dilon 6800 Gamma Camera and optimized the camera for breast imaging. Dilon's system provides metabolic information about breast tissue health not previously available from other imaging modalities. Ongoing research with the national lab in Newport News, Virginia and notable academic institutions is further expanding the imaging applications of the Dilon 6800 Gamma Camera and the development of additional imaging products.

BSGI Website Link

To learn more about Breast-Specific Gamma Imaging with the Dilon 6800 Gamma Camera visit: www.dilon.com

Case Studies

Web Streaming Video Disclaimer

The physician and patient statements in this video are their own opinions based on their individual experiences relative to Breast-Specific Gamma Imaging and the Dilon 6800. Although Breast-Specific Gamma Imaging (BSGI) is a strong diagnostic tool, like all forms of medical imaging it is not perfect. BSGI is considered to be an adjunctive procedure to mammography, and should be used with the same limitations as with all medical imaging.

BSGI Videos

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