Third Molar Maturity Index as an Efficient Tool for Prediction of Age in a Sample Indian Population - A Retrospective Study

Introduction: The age of 18 years is an important milestone for legal matters, and developmental parameters of teeth are often used for estimation of this age. The aim of this study is to assess the efficiency of third molar maturity index (I3M) in establishing age of 18 years in Dakshina Kannada population. Methods: A total of 700 orthopantomograms were retrieved from the archives of the radiology department of Manipal College of Dental Sciences, Mangalore. The length and the width of the open apex of the mandibular left third molar was assessed using Image J software and the Third molar maturity Index (I3M) was calculated and correlated with the age of the individual. Results: Receiver operating characteristic (ROC) curve analysis showed the Area under curve of 0.94 and 0.96 in females and males, respectively, for prediction of age of 18 years. The cut?off of 0.08 predicted the 18?year cut?off with 97% specificity and 90.2% negative predictive value. The percentage of the accuracy was 80.23% if the I3M was <0.08. Conclusion: The efficiency of the cut?off of 0.08 of I3M has been tested in various population including Kosovar, Peruvian, South Indian, Libyan, Montenegro, Croatian, African (Botswana), Albanian, and Serbian. Our study also shows the efficiency of the same in South Indian Dakshina Kannada population.

Reasonably conduct the multiple Logistic regression analysis combined with the ROC curve analysis / 四川精神卫生

The purpose of this paper was to introduce how to reasonably carry out the method of the multiple Logistic regression analysis by combining the ROC curve analysis. Firstly， it introduced two groups of the basic concepts related to the ROC curve analysis， that was， the statistical description of common diagnostic indicators and the ROC curve analysis method of the diagnostic data. Secondly， it introduced the core contents of the ROC curve analysis， that was， the calculation of the area under the ROC curve and the comparison of the area under multiple ROC curves. Thirdly， through an example of a diagnostic test， the whole process of how to use SAS software for the analysis was introduced， the contents were as follows： ① the analysis using only multiple Logistic regression analysis； ② the multiple Logistic regression analysis combined with the ROC curve analysis. The conclusion was that， for the diagnostic test data， combining the multiple Logistic regression analysis with the ROC curve analysis could obtain richer and more reasonable statistical analysis results.

Characteristics and ROC curve analysis of ankle injury in Kashin-Beck disease / 西安交通大学学报(医学版)

Objective :To investigate the characteristics of ankle talus by CT scanning in patients with Kashin-Beck disease. Methods: We included 40 patients with ankle pain for this study. CT examination was carried out to measure talus diameter, i.e., from the upper at inside to the lower at outside and from the upper at outside to the lower at inside in coronal direction; from the upper at front to the lower at behind, from upper at front to the upper at behind in sagittal direction. The statistically significant indexes were included in the ROC curve analysis. Results :CT measurement of the talus in ankle joints showed that the distance of the talus in ankle joints from the upper at outside to the lower at inside (3.76±0.34)cm, the upper at front to the lower at behind (4.98±0.36)cm in KBD group were significantly lower than those in OA group (4.26±0.34)cm and (5.40±0.37)cm, which was significantly difference (t=-3.599, 4.646, P=0.00). ROC curve analysis showed that there was significant difference between KBD group and OA group, and the cut-off value of the distance from the upper at outside to the lower at inside was 4.055cm, with sensitivity of 70% and specificity of 90%. When the cut-off value of the distance from the upper at front to the lower at behind was 5.41cm, the sensitivity was 65% and the specificity was 95%. Conclusion: The distance of the talus of KBD ankle joints from the upper at outside to the lower at inside (cut-off value of 4.055 cm) in coronal direction and the upper at front to the lower at behind (cut-off value was 5.41 cm) in sagittal direction can be used as specific diagnostic indicators of ankle joint damage for KBD in adults.

Correlation between neutrophil lymphocyte ratio and acute cerebral infarction / 医学研究生学报

Objective Cerebral infarction is characterized by high morbidity, high mortality and high disability. The aim of this study is to explore the correlation between neutrophil lymphocyte ratio and acute cerebral infarction(ACI), providing references for the prevention and treatment of ACI.Methods In this study, 111 patients with ACI admitted to the Department of Neurology of Jiangsu Provincial People′s Hospital from April 2017 to October 2017 were enrolled in the retrospective analysis and divided into 3 subgroups according to the infarct size: small area ACI group (diameter3.0 cm, n=31). A number of 107 healthy subjects were included as control group. Baseline data and blood test indicators were collected and compared between groups.Results Compared with the control group, the level of sex, smoking, drinking, hypertension, diabetes, hyperlipidemia, white blood cells, neutrophils and NLR in patients with acute cerebral infarction were higher（all P<0.05）. The white blood cell count and NLR of large area group were higher than those of small area and medium area group. The white blood cell count and NLR of large area group were higher than those of small area and middle area group, and the difference was statistically significant. Multivariate logistic regression analysis showed that smoking (OR=3.468, P=0.003), hypertension (OR=8.764, P=0.000), hyperlipidemia (OR=2.867, P=0.020), and NLR (OR=3.016, P=0.000) were risk factors for acute cerebral infarction. The area under the ROC curve of neutrophil lymphocyte ratio was 0.773, and the best diagnostic value was 2.13.Conclusion NLR is a risk factor for ACI, and has a predictive effect on the occurrence of ACI.

New index for the diagnosis of liver fibrosis in Schistosomiasis mansoni / Novo índice biológico para o diagnóstico da fibrose hepática na Esquistossomose mansoni

ABSTRACT BACKGROUND Periportal fibrosis is the major pathological consequence of the Schistosoma mansoni infection. OBJECTIVE To evaluate the accuracy of serum markers and to construct an index to assess fibrosis. METHODS Patients (n=116) with schistosomiasis were evaluated by ultrasound scan and measurements of serum levels of aminotransferases, γ-glutamyl transferase, alkaline phosphatase, hyaluronic acid, cytokines and platelets. Ultrasound images were used to evaluate the fibrosis using Niamey's classification and identified 19 patients without periportal fibrosis (patterns A and B), 48 with mild to moderate fibrosis (C and D) and 49 with advanced fibrosis (E and F). RESULTS Using multivariate analysis, a model was created, which involved alkaline phosphatase and platelets and could separate patients with different patterns of fibrosis. This index showed a better performance in separating patients without fibrosis from with advanced periportal fibrosis. The biological index showed an area under the ROC curve of 1.000. Using values below the lowest or above the highest cut-off point, the presence or absence of advanced fibrosis could be predicted in all patients. CONCLUSION The index constructed can be used to separate patients with different patterns of periportal fibrosis, specially to predict advanced fibrosis in schistosomiasis patients.

RESUMO CONTEXTO A fibrose periportal é a maior consequência patológica da infecção pelo Schistosoma mansoni. OBJETIVO Avaliar a acurácia de marcadores séricos e construir um índice para avaliar a fibrose. MÉTODOS Pacientes (n=116) com esquistossomose foram avaliados pela ultrassonografia e dosados os níveis de aminotransferases, γ-glutamil transferase, fosfatase alcalina, ácido hialurônico, citocinas e plaquetas. Imagens de ultrasom foram utilizadas para avaliar a fibrose através de classificação de Niamey e identificados 19 pacientes sem fibrose periportal (padrão A e B), 48 com fibrose média a moderada (C e D) e 49 com fibrose avançada (E e F). RESULTADOS Através de análise multivariada, um modelo foi criado, que envolveu a fosfatase alcalina e plaquetas e conseguiu separar pacientes com diferentes padrões de fibrose periportal. Este índice mostrou um melhor desempenho em separar pacientes sem fibrose dos pacientes com fibrose avançada. O índice biológico mostrou uma área sob a curva ROC de 1,000. Usando valores infereiores e acima do ponto de corte, a presença ou ausência de fibrose avançada pode ser prevista em todos os pacientes. CONCLUSÃO O índice construído pode ser usado para separar os pacientes com diferentes padrões de fibrose periportal, especialmente para prever fibrose avançada em pacientes com esquistossomose.

A Validation Study of the Korean Version of Social Communication Questionnaire

OBJECTIVES: The purposes of this study were to examine the reliability and validity of the Korean version of Social Communication Questionnaire (K-SCQ) and to determine cut-off scores for diagnosis of autism spectrum disorder (ASD). METHODS: A total of 166 subjects with ASD and their 186 unaffected siblings were recruited through child psychiatry clinics of university hospitals. Board certified child psychiatrists screened all probands suspected to have ASD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. To confirm the diagnoses, the Korean versions of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised (K-ADI-R) were administered to all the subjects. All parents completed the K-SCQ and Social Responsiveness Scale (SRS). The non-ASD siblings were evaluated with the same instruments as the probands with ASD. We performed a factor analysis to examine the structure of K-SCQ. For testing the validity of K-SCQ, we compared the difference in Lifetime and Current scores of probands with ASD and their non-ASD siblings using t-test and analysis of covariance. Correlations between the K-SCQ and other measurements of ASD symptomatology, including K-ADI-R totals and domain scores and SRS, were examined. Receiver operation characteristic curve analysis was performed to extract cutoff scores discriminating affection status. RESULTS: Four factors were extracted through factor analysis of K-SCQ ; 1) social relation and play, 2) stereotyped behavior, 3) social behavior, and 4) abnormal language. Cronbach's internal consistency was .95 in K-SCQ Lifetime, and .93 in K-SCQ Current. There were significant differences in total score of K-SCQ, both in Lifetime and Current between the ASD group and non-ASD siblings group (p<.001). K-SCQ scores were significantly correlated with K-ADI-R subdomain scores and SRS total scores (p<.001). The best-estimate cut-off scores of K-SCQ for diagnosis of ASD were 12 for 48 months and over, and 10 for below 47 months. CONCLUSION: Our findings suggest that the K-SCQ is a reliable and valid instrument for screening autistic symptoms in the Korean population. Lower cut-off scores than the original English version might be considered when using it as a screening instrument of ASD.

Validation of the Korean Version of the Children's Revised Impact of Event Scale

OBJECTIVE: This study examined the psychometric properties of the Korean version of the Children's Revised Impact of Event Scale (CRIES) and its validity as a screening instrument for the post-traumatic stress disorder (PTSD). METHODS: The study population consisted of two samples. The clinical sample consisted of 60 child and adolescent patients from the Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine. The normal sample consisted of 291 students from four schools (primary, middle, and high schools). We administered four self-report questionnaires (the CRIES, Child Reports of Post-traumatic Symptoms [CROPS], State-Trait Anxiety Inventory for Children [STAI-C], and Children's Depression Inventory [CDI]) to 351 children and adolescents after obtaining informed consent from all participants and their parents. RESULTS: The CRIES showed good reliability (Cronbach's alpha for the full scale and subscales ranged from 0.85 to 0.93). The total CRIES score was positively correlated with CROPS, STAI-C, and CDI. Confirmatory factor analysis indicated that a three-factor structure for the CRIES (intrusion, avoidance, and hyper-arousal) had a significantly better fit than a two-factor model (intrusion/hyper-arousal and avoidance). Receiver operating characteristic curve analysis indicated that a cutoff of 26 offered the optimum predictive point. That is, this cutoff maximized the balance between sensitivity (0.88) and specificity (0.85). Using this cutoff, the positive predictive value was 0.86, and the negative predictive value was 0.99. CONCLUSION: These findings imply that the CRIES is a highly accurate diagnostic test in clinical settings.

Using receiver operating characteristic curve analysis in detecting excess adiposity in 9-13-year old South African children / Uso del análisis de la curva de las características operativas del receptor (ROC) para detectar el exceso de adiposidad en niños Sudafricanos de 9 a 13 años de edad

OBJECTIVE: Little is known concerning the applicability of receiver operating characteristic (ROC) curve analysis in detecting excess adiposity in preadolescent South African children. Therefore, the purpose of this study was to evaluate the sensitivity and specificity of body mass index (BMI) and skinfold thickness:BMI (subcutaneous to overall fat) in detecting excess adiposity in preadolescent urban South African school children. METHODS: This was a cross-sectional survey of 1136 randomly selected children (548 boys and 588 girls) aged 9-13 years old in urban (Pretoria Central) South Africa. Body mass, stature, skinfolds (subscapular, triceps, supraspinale and biceps) and waist circumference were measured. Receiver operating characteristic curve analysis was used to assess the sensitivity and specificity of BMI, and log10 SF4:BMI to detect excess adiposity. Excess adiposity was defined as levels of log10 SF4 greater than the internally derived 85th percentile (log10 SF4 > 85th percentile). RESULTS: Compared to log10 SF4:BMI, BMI had a high specificity (0.88; 95% CI 0.84, 0.90). The log10 SF4:BMI identified excess adiposity with a sensitivity and specificity of 0.62 (95% CI 0.60, 0.67) and 0.68 (95% CI 0.64, 0.70), respectively. Besides, a decrease in overall misclassification with the use of log10 SF4:BMI instead of BMI at the 95th percentile (9.7% versus 27.1%) was observed. CONCLUSION: Similar to other studies, although with varying degrees, the present study confirms that log10 SF4:BMI at conventional cut-off points has a relatively high sensitivity and specificity in detecting excess adiposity, and therefore could be used to identify the excess adiposity in South African children. As such, defining obesity based on population-specific percentiles rather than using cut-off points derived from other geographical settings with contrasting levels of socio-economic development becomes imperative.

OBJETIVO: Poco se sabe acerca de las posibilidades de aplicación del análisis de la curva de las características operativas del receptor (ROC) para detectar el exceso de adiposidad en preadolescentes sudafricanos. Por consiguiente, el propósito de este estudio fue evaluar la sensibilidad y especificidad del índice de masa corporal, y grosor de los pliegues cutáneos:IMC (subcutáneo con respecto a la grasa general) a la hora de detectar el exceso de adiposidad en los escolares preadolescentes urbanos de Sudáfrica. MÉTODOS: Se realizó un estudio transversal de 1136 niños seleccionados de manera aleatoria (548 varones y 588 hembras) de 9 a 13 años de edad en la Sudáfrica urbana (Pretoria Central). Se midieron la masa corporal, la estatura, los pliegues cutáneos (subescapular, supraespinal, así como del tríceps y el bíceps) y la circunferencia de la cintura. Se hizo uso del análisis de la curva de las características operativas del receptor para evaluar la sensibilidad y especificidad del IMC, y el log10 PC4: IMC, a fin de detectar el exceso de adiposidad. El exceso de adiposidad fue definido en términos de la medida en que los niveles del log10 PC4 fueran mayores que el percentil 85 (log10 PC4 > percentil 85). RESULTADOS: Comparado con el log10 SF4:IMC, el IMC tenía una alta especificidad (0.88; 95% CI 0.84, 0.90). El log10 SF4:IMC identificó exceso de adiposidad con una sensibilidad y especificidad de 0.62 (95% CI 0.60, 0.67) y 0.68 (95% CI 0.64, 0.70), respectivamente. Además, una disminución en los errores de clasificación global con el uso del log10 SF4:IMC en lugar del IMC en el percentil 95 (9.7% frente a 27.1%) se observó. CONCLUSIÓN: Similar a otros estudios, aunque con diferencias de grados, el estudio presente confirma que el log10 SF4:IMC a ciertos puntos convencionales límites, posee una sensibilidad y una especificidad relativamente altas a la hora de detectar la adiposidad en exceso, y por consiguiente podría usarse para identificar el exceso de adiposidad en los niños sudafricanos. Siendo así, resulta imperativo definir la obesidad sobre la base de los percentiles específicos de la población, más bien que a partir del uso de puntos de corte derivados de otros sitios geográficos con niveles contrastantes de desarrollo económico.

Evaluation of Waist Circumference Cut-off Values as a Marker for Fatty Liver among Japanese Workers

OBJECTIVES: Metabolic syndrome has received attention as a risk factor for cardiovascular disease, with particular importance attached to visceral fat accumulation, which is associated with lifestyle-related diseases and is strongly correlated with waist circumference. In this study, our aim is to propose waist circumference cut-off values that can be used as a marker for fatty liver based on a sample of workers receiving health checkups in Japan. METHODS: This study was conducted in a total of 21,866 workers who underwent periodic health checkups between January 2007 and December 2007. The mean age of the subjects was 47.4 years for men (standard deviation [SD]: 8.0) and 44.7 years for women (SD: 6.9). Evaluation included abdominal ultrasound and measurement of waist circumference, body mass index, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure. RESULTS: Based on receiver operating characteristic curve analysis, the optimal waist circumference cut-off values were shown as 85.0 cm (sensitivity 0.72, specificity 0.69) for men and 80.0 cm (sensitivity 0.75, specificity 0.78) for women. CONCLUSION: Abdominal ultrasound is the most efficient means of diagnosing fatty liver, but this examination seldom occurs because the test is not routinely performed at workers' health checkups. In people found to have a high risk of fatty liver, recommendations can be made for abdominal ultrasound based on the waist circumference cut-off values obtained in this study. That is, waist circumference can be used in high risk individuals as an effective marker for early detection of fatty liver.

Evaluation of Waist Circumference Cut-off Values as a Marker for Fatty Liver among Japanese Workers

OBJECTIVES: Metabolic syndrome has received attention as a risk factor for cardiovascular disease, with particular importance attached to visceral fat accumulation, which is associated with lifestyle-related diseases and is strongly correlated with waist circumference. In this study, our aim is to propose waist circumference cut-off values that can be used as a marker for fatty liver based on a sample of workers receiving health checkups in Japan. METHODS: This study was conducted in a total of 21,866 workers who underwent periodic health checkups between January 2007 and December 2007. The mean age of the subjects was 47.4 years for men (standard deviation [SD]: 8.0) and 44.7 years for women (SD: 6.9). Evaluation included abdominal ultrasound and measurement of waist circumference, body mass index, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure. RESULTS: Based on receiver operating characteristic curve analysis, the optimal waist circumference cut-off values were shown as 85.0 cm (sensitivity 0.72, specificity 0.69) for men and 80.0 cm (sensitivity 0.75, specificity 0.78) for women. CONCLUSION: Abdominal ultrasound is the most efficient means of diagnosing fatty liver, but this examination seldom occurs because the test is not routinely performed at workers' health checkups. In people found to have a high risk of fatty liver, recommendations can be made for abdominal ultrasound based on the waist circumference cut-off values obtained in this study. That is, waist circumference can be used in high risk individuals as an effective marker for early detection of fatty liver.

Gender Differences in Diagnostic Values of Visceral Fat Area and Waist Circumference for Predicting Metabolic Syndrome in Koreans

Abdominal fat accumulation is known to be strongly implicated in development of metabolic syndrome (MetS). We examined diagnostic values of obesity-related parameters in 95 men and 185 women, and we determined optimal cutoff values of visceral fat area (VFA) and waist circumference (WC) for predicting the presence of multiple non-adipose components of MetS. Receiver operating characteristic (ROC) curve analysis revealed that VFA was the best indicator of MetS. WC and VFA exhibited similar diagnostic values for men and postmenopausal women, whereas WC was inferior to VFA for premenopausal women (area under ROC curve of VFA and WC was 0.76 and 0.52, respectively; P < 0.001). Optimal cutoff points of VFA and WC for predicting MetS were 136 cm2 and 89 cm in men and 95 cm2 and 82 cm in women, respectively. Subjects with VFA and WC above these cutoff values exhibited increased insulin resistance and increased carotid intima-media thickness. In conclusion, WC has a diagnostic value similar to VFA for predicting MetS in men and postmenopausal women, but not in premenopausal women. Further studies are necessary to develop a simple clinical parameter that reflects visceral fat in premenopausal women.

Comparative antibody response of five recombinant antigens in related to bacterial shedding levels and development of serological diagnosis based on 35 kDa antigen for Mycobacterium avium subsp. paratuberculosis

Eighty-five complex (85A, 85B and 85C), 35-kDa and superoxide dismutase (SOD) were cloned, expressed and purified as antigens in an enzyme-linked immunosorbent assay (ELISA) to compare the serological reactivity of cows with different shedding levels of Mycobacterium avium subsp. paratuberculosis (MPT). Antibody responses to all recombinant antigens positively increased depending on shedding levels. In particular, antibody responses to the 35 kDa were higher than those to the others in all shedder groups. Also, the mean of O. D. values among Ag 85 complex, 85B showed slightly higher response than others with high sensitivity and specificity in all shedder groups. In receiver operating characteristic (ROC) curve analysis, the result of 35 kDa ELISA yielded an area under the curve value of 0.945 (95% confidence interval = 0.895 . 0.996), which indicated that this 35 kDa is more accurate indicator of MPT infection than other antigens. At the cut-off point recommended by the ROC curve analysis, the sensitivity and specificity of 35 kDa ELISA were higher than those of other antigens with 93.3% and 86.4%, respectively. Finally, a commercially available ELISA kit was used to clarify 200 positive and 200 negative sera. We then re-tested these serum samples with our ELISA test using the 35-kDa antigens. 35 kDa ELISA and commercial kit showed almost similar results in ROC curve analysis even though two of positive sera in commercial kit were negative in 35 kDa ELISA. The sera, which showed difference in the comparison with commercial ELISA kit, they also did not react with 35 kDa in Western blot. These results suggest that a 35-kDa based ELISA can be useful for detecting MPT infection.

Diagnostic Accuracy of Quantitative Scintimammography Using Tc-99m Tetrofosmin according to ROC Curve Analysis for Breast Cancer / 한국유방암학회지

PURPOSE: Tc-99m Tetrofosmin is a new alternative to Tc- 99m MIBI for nuclear breast imaging. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the feasibility of Tc-99m Tetrofosmin quantitative scintimammography (SMM) (qSMM) and to compare with previously reported Tc-99m MIBI qSMM data [J Kor Surg 1999;57(5):638-644)]. METHODS: Prone anterior, lateral planar and supine SPECT images were taken from 135 cases in 131 female patients (mean ages=44 yr) with breast mass (size> or =0.2 cm) after 30mCi intravenous injection of Tc-99m Tetrofosmin. 70 malignant and 65 benign lesions were histologically proven. Three regions of interest (ROIs) were drawn over designated areas: the Lesion (L), the Normal breast opposite the lesion (NL) and the right Chest wall (CW). L/NL and L/CW ratios on both the SPECT and the planar images were analyzed. RESULTS: ROC curve analysis revealed that the planar L/NL ratio and the SPECT L/NL and L/CW ratios had higher diagnostic accuracy for detecting breast cancer than he planar L/CW ratio did (P<0.05). The qSMM (mean), which is an arithmetic mean of the planar L/NL ratio, the SPECT L/NL ratio and the SPECT L/CW ratio, the sensitivity, the specificity, accuracy and area under curve (AUC) were 82.9%, 81.5%, 82.2% and 0.879 respectively. Presence of axillary lymph node metastasis showed a slightly higher qSMM (mean) value (2.79 {n=23} vs 2.75 {n=27} P=0.06). These are comparable with previously reported Tc-99m MIBI qSMM data of 84.4%, 76.6%, 81.0% and 0.847 respectively, and the presence of axillary lymph node metastasis showed a higher qSMM(mean) value (4.09 {n=17} vs 3.09 {n=28}, P=0.06) [J Kor Surg 1999; 57(5):638-644)]. CONCLUSION: Tc-99m Tetrofosmin qSMM (mean) is a useful and objective method for differentiating malignant from benign breast lesion and has the comparable diagnostic accuracies of Tc-99m MIBI qSMM.

Diagnostic Accuracy of Quantitative Scintimammography Using Tc-99m MIBI According to ROC Curve Analysis for Breast Cancer

BACKGROUND: Technetium-99m sestamibi scintimammography (SMM) has been shown to be a useful diagnostic test in the detection of breast cancer, and the receiver operating characteristic (ROC) curve analysis provides detailed information about the diagnostic test. A ROC curve analysis was performed to evaluate the feasibility of Tc-99m sestamibi quantitative scintimammography (qSMM) for differentiating malignant from benign breast lesions. METHODS: Prone anterior, lateral planar, and supine SPECT imagings were performed on 75 female patients (mean age=43.4 yr) with breast masses (size> or =0.8 cm) after intravenous injection of 30 mCi of Tc-99m sestamibi. 45 malignant and 30 benign lesions were histologically proven. Three regions of interest (ROIs) were drawn over designated areas: lesion (L), normal breast opposite to the lesion (NL), and right chest wall (CW). L/NL and the L/CW ratios on both the SPECT and the planar images were analyzed. RESULTS: ROC curve analysis revealed that planar L/NL ratio and the SPECT L/NL and L/CW ratios provide better diagnostic accuracies for detecting breast cancer than the planar L/CW ratio did (p<0.05). From the qSMM (mean), which was an arithmetic mean of the planar L/NL, ratio the SPECT L/NL ratio and the SPECT L/CW ratio, the sensitivity, the specificity, the positive predictive value, the negative predictive value, and the accuracy were 84%, 77%, 84%, 77%, and 81%, respectively. Presence of axillary lymph-node metastasis showed a higher qSMM (mean) value (4.09 {n=17} vs 3.09 {n=28}, p=0.06). CONCLUSIONS: qSMM (mean) is a useful objective method for differentiating malignant from benign breast lesions.