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Table 2 Diagnostic performance of each type of MBI acquisition

From: Half-time Tc-99m sestamibi imaging with a direct conversion molecular breast imaging system

  Reader 1 Reader 2
  10 min-per-view 5 min-per-view 5 min-per-view with WBR p value* 10 min-per-view 5 min-per-view 5 min-per-view with WBR p value*
     10 min vs. 5 min 10 min vs. 5 min WBR 5 min vs. 5 min WBR     10 min vs. 5 min 10 min vs. 5 min WBR 5 min vs. 5 min WBR
  No. of breasts 95% CIs No. of breasts 95% CIs No. of breasts 95% CIs   No. of breasts 95% CIs No. of breasts 95% CIs No. of breasts 95% CIs    
Detection of both malignant and benign lesions                 
 Sensitivity for all lesions*** 40/49 (82) 68.6, 90.0 33/49 (67) 53.4, 78.8 32/49 (65) 51.3, 77.1 0.04 0.02 1.00 43/49 (88) 75.8, 94.3 36/49 (74) 59.7, 83.8 37/49 (76) 61.9, 85.4 0.02 0.03 1.00
  Lesions ≤10 mm 13/17 (77) 52.7, 90.4 9/17
(53)
31.0, 73.8 7/17
(41)
21.6, 64.0 0.13 0.03 0.50 12/17 (71) 46.9, 86.7 8/17
(47)
26.2, 69.0 9/17
(53)
31.0, 73.8 0.13 0.25 1.00
  Lesions >10 mm 27/32 (84) 68.2, 93.1 24/32 (75) 57.9, 86.7 25/32 (78) 61.2, 89.0 0.38 0.63 1.00 31/32 (97) 84.3, 99.4 28/32 (88) 71.9, 95.0 28/32 (88) 71.9, 95.0 0.25 0.25 1.00
   p value ≤ 10 mm vs. > 10 mm** 0.70 0.20 0.01   0.02 0.01 0.01  
  Mild intensity lesions 11/18 (61) 38.6, 79.7 5/18
(28)
12.5, 50.9 4/18
(22)
9.0, 45.2 0.03 0.02 1.00 12/18 (67) 43.7, 83.7 7/18
(39)
20.3, 61.4 7/18
(39)
20.3, 61.4 0.06 0.06 1.00
  Moderate/Marked intensity lesions 29/31 (94) 79.3, 98.2 28/31 (90) 75.1, 96.7 28/31 (90) 75.1, 96.7 1.00 1.00 NDP 31/31 (100) 89.0, 100 29/31 (94) 79.3, 98.2 30/31 (97) 83.8, 99.4 NDP NDP 1.00
   p value, mild vs. moderate/high intensity** 0.01 <0.001 <0.001   0.001 <0.001 <0.001  
  Low image count density 7/8
(88)
52.9, 97.8 7/8
(88)
52.9, 97.8 6/8
(75)
40.9, 92.9 NDP 1.00 1.00 7/8
(88)
52.9, 97.8 6/8
(75)
40.9, 92.9 7/8
(88)
52.9, 97.8 1.00 NDP 1.00
  Intermediate/high image count density 33/41 (81) 66.0, 89.8 26/41 (63) 48.1, 76.4 26/41 (63) 48.1, 76.4 0.04 0.04 1.00 36/41 (88) 74.5, 94.7 30/41 (73) 58.1, 84.3 30/41 (73) 58.1, 84.3 0.03 0.03 1.00
   p value, low vs. intermediate/high image count density** 1.00 0.25 0.70   1.00 1.00 0.66  
 Specificity 115/115 (100) 96.8, 100.0 114/115 (99) 95.2, 99.8 115/115 (100) 96.8, 100.0 1.00 NDP 1.00 115/115 (100) 96.8, 100.0 114/115 (99) 95.2, 99.8 115/115 (100) 96.8, 100.0 1.00 NDP 1.00
  AUC 95% CIs AUC 95% CIs AUC 95% CIs     AUC 95% CIs AUC 95% CIs AUC 95% CIs    
 ROC analysis 99.4 98.8, 99.9 91.9 86.5, 97.4 93.8 89.1, 98.4 0.01 0.02 0.39 99.8 99.6, 100.0 93.4 88.5, 98.2 96.0 92.2, 99.8 0.01 0.04 0.23
Detection of malignant lesions only                   
 Sensitivity for malignant lesions 29/33 (88) 72.7, 95.2 26/33 (79) 62.2, 89.3 27/33 (82) 65.6, 91.4 0.25 0.50 1.00 31/33 (94) 80.4, 98.3 29/33 (88) 72.7, 95.2 28/33 (85) 69.1, 93.3 0.50 0.25 1.00
  Cancers ≤10 mm 6/8
(75)
40.9, 92.9 5/8
(63)
30.6, 86.3 5/8
(63)
30.6, 86.3 1.00 1.00 NDP 6/8
(75)
40.9, 92.9 5/8
(63)
30.6, 86.3 5/8
(63)
30.6, 86.3 1.00 1.00 NDP
  Cancers >10 mm 23/25 (92) 75.0, 97.8 21/25 (84) 65.3, 93.6 22/25 (88) 70.0, 95.8 0.50 1.00 1.00 25/25 (100) 86.7, 100 24/25 (96) 80.5, 99.3 23/25 (92) 75.0, 97.8 1.00 1.00 1.00
   p value ≤ 10 mm vs. > 10 mm** 0.24 0.32 0.14   0.053 0.036 0.080  
  Mild intensity cancers 5/9
(56)
26.7, 81.1 3/9
(33)
12.1, 64.6 4/9
(44)
18.9, 73.3 0.50 1.00 1.00 7/9
(78)
45.3, 93.7 6/9
(67)
35.4, 87.9 4/9
(44)
18.9, 73.3 1.00 0.25 0.50
  Moderate/marked intensity cancers 24/24 (100) 86.2, 100 23/24 (96) 79.8, 99.3 23/24 (96) 79.8, 99.3 1.00 1.00 NDP 24/24 (100) 86.2, 100 23/24 (96) 79.8, 99.3 24/24 (100) 86.2, 100 1.00 1.00 1.00
   p value, mild vs. moderate/high intensity** 0.003 < 0.001 0.003   0.068 0.052 < 0.001  
  Low image count density 6/7
(86)
48.7, 97.4 6/7
(86)
48.7, 97.4 6/7
(86)
48.7, 97.4 NDP NDP NDP 6/7
(86)
48.7, 97.4 6/7
(86)
48.7, 97.4 6/7
(86)
48.7, 97.4 NDP NDP NDP
  Intermediate/high image count density 23/26 (89) 71.0, 96.0 20/26 (77) 58.0, 89.0 21/26 (81) 62.1, 91.5 0.25 0.50 1.00 25/26 (96) 81.1, 99.3 23/26 (89) 71.0, 96.0 22/26 (85) 66.5, 93.8 0.50 0.25 1.0
   p value, low vs. intermediate/high image count density** 1.00 1.00 1.00   0.38 1.00 1.00  
 Specificity 120/131 (92) 85.6, 95.2 123/131 (94) 88.4, 96.9 126/131 (96) 91.4, 98.4 0.45 0.07 0.25 119/131 (91) 84.7, 94.7 123/131 (94) 88.4, 96.9 122/131 (93) 87.5, 96.3 0.22 0.25 1.00
  AUC 95% CIs AUC 95% CIs AUC 95% CIs     AUC 95% CIs AUC 95% CIs AUC 95% CIs    
 ROC analysis 96.0 93.6, 98.3 95.0 90.9, 99.1 96.9 94.3, 99.0 0.56 0.45 0.21 96.1 93.9, 98.3 94.9 90.8, 98.9 94.7 90.6, 98.7 0.47 0.38 0.93
  1. Diagnostic performance of each type of MBI acquisition interpreted independently by two readers, first considering detection of both malignant and benign lesions and second considering detection of only malignant lesions. Numbers in parentheses are percentages, and percentages are rounded.MBI, molecular breast imaging; WBR, wide beam reconstruction; NDP, unable analyze due to lack discordant pairs. A per-breast final assessment of 1, 2, or 3 was considered test negative, and final assessment of 4 or 5 was considered test positive. Lesion size and intensity classification were determined at case selection based on the clinically interpreted MBI report of the 10-min-per-view acquisitions. Image count density was measured in the background (non-lesion) region of benign breast tissue on the 10-min-per-view MBI acquisition. Count density was defined as low (<1,150 counts/cm2), intermediate (1,150 to 1,750 counts/cm2), or high (>1,750 counts/cm2). *p values for sensitivity and specificity were calculated using McNemar’s test for correlated proportions, p values for ROC results were calculated using Chi-square analysis, and p values for image quality scores were calculated using Wilcoxon signed-rank test. **p values were calculated using Fisher’s exact probability test. ***Results for sensitivity for all lesions are given for 49 breasts with lesions (33 malignant and 16 benign) in 48 patients. One patient had a single benign lesion in each breast.