99Tcm-MIBI scintimammography in the evaluation of breast lesions and axillary involvement

Arslan, Nuri; Öztürk, Erkan; Ilgan, Seyfettin; Urhan, Muammer; Karaçalioğlu, Özgür; Pekcan, Mesut; Tufan, Turgut; Bayhan, Hi̇kmet

doi:10.1097/00006231-199904000-00007

Cited by 31 publications

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“…A meta-analysis of scintimammographic studies using a traditional, general purpose gamma camera demonstrated an average sensitivity of 84% for breast cancer detection, although many of the cancers included in these studies were palpable and larger [7]. However, scintimammography with a general purpose gamma camera is limited in the detection of non-palpable cancers and cancers less than 1 cm in size because of intrinsic resolution limitations [8][9][10][11]. Another limitation is the inability of a general purpose gamma camera to image in positions comparable to those obtained with mammography, limiting the ability to correlate between these two modalities.…”

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confidence: 99%

Breast-specific gamma imaging as an adjunct modality for the diagnosis of invasive breast cancer with correlation to tumour size and grade

Tadwalkar

Rapelyea

Torrente

et al. 2012

BJR

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Objectives: The purpose of this study was to determine the sensitivity of breastspecific gamma imaging (BSGI) in the detection of invasive breast cancers and to characterise the sensitivity of BSGI based on tumour size and pathological grade. Methods: 139 females with invasive carcinoma who underwent BSGI were retrospectively reviewed. Patients were injected in the antecubital vein with 20-30 mCi (925-1110 MBq) of 99m Tc-sestamibi. Images were obtained with a high-resolution, breast-specific gamma camera (Dilon 6800; Dilon Technologies, Newport News, VA) and were categorised based on radiotracer uptake as normal, normal with heterogeneous uptake, probably abnormal and abnormal. For a positive examination, the region of the area of increased uptake had to correlate with the laterality and location of the biopsy-proven cancer. Results: 149 invasive cancers in 139 patients with a mean size of 1.8 cm (0.2-8.5 cm) were included. 146 were identified with BSGI (98.0%). All cancers which measured $0.7 cm (n5123) as well as all cancers grade 2 or higher (n5102), regardless of tumour size, were identified with BSGI (100%). There were 6 cancers that were pathological grade 1 and measured ,7 mm, of which 50% (3/6) were identified with BSGI. The overall sensitivity of BSGI for the detection of invasive breast cancer is 98.0%. The sensitivity for subcentimetre cancers is 88.5% (23/26). Conclusion: BSGI has a high sensitivity for the detection of invasive breast cancer. Our results demonstrate that BSGI detected all invasive breast cancers pathological grade 2 and higher regardless of size and all cancers which measured $7 mm regardless of grade. BSGI can reliably detect invasive breast cancers and is a useful adjunct imaging modality for the diagnosis of breast cancer. Mammography has remained the modality of choice for breast cancer screening. Nevertheless, it is an imperfect examination with a sensitivity of 78-85% that declines to 68% in females with dense breasts [1][2][3][4][5][6]. The limitations of mammography have resulted in the development of adjunct imaging modalities to improve breast cancer detection. Most frequently, ultrasound is used in conjunction with mammography as an adjunct imaging modality for breast cancer diagnosis, particularly in females with dense breasts [2].Mammography and ultrasound are both anatomical approaches for the diagnosis of breast cancer. Nuclear medicine techniques that utilise physiological properties of tumours are increasingly being used. A meta-analysis of scintimammographic studies using a traditional, general purpose gamma camera demonstrated an average sensitivity of 84% for breast cancer detection, although many of the cancers included in these studies were palpable and larger [7]. However, scintimammography with a general purpose gamma camera is limited in the detection of non-palpable cancers and cancers less than 1 cm in size because of intrinsic resolution limitations [8][9][10][11]. Another limitation is the inability of a general purpose gamma camera to image in positions...

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confidence: 99%

Breast-specific gamma imaging as an adjunct modality for the diagnosis of invasive breast cancer with correlation to tumour size and grade

Tadwalkar

Rapelyea

Torrente

et al. 2012

BJR

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“…99m Tc-MIBI has been shown to have a very high sensitivity and specificity in the detec- tion of primary breast cancer [4][5][6][7][8][9]. Nevertheless, it requires a process of boiling and cooling before injection in patients, and has the risk of radiation exposure during that time.…”

Section: Discussionmentioning

confidence: 99%

“…Among the various radiopharmaceuticals, 99m Tc-MIBI, developed as a myocardial perfusion-imaging agent, has been reported to have a very high sensitivity and specificity for the diagnosis of primary and recurrent breast cancer [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Technetium-99m-Tetrofosmin Scintimammography in Suspected Breast Cancer Patients: A Comparison with Technetium-99m-MIBI

Kim

et al. 2000

Med Princ Pract

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Objective: To investigate the diagnostic role of ^99mTc-tetrofosmin in the detection of primary breast cancer and axillary lymph node metastasis and to compare the findings with those of ^99mTc-MIBI. Methods: Forty-eight patients with clinically palpable masses or abnormal radiologic findings had ^99mTc-MIBI and ^99mTc-tetrofosmin scintimammographies (SMMs) after intravenous injections of 925 MBq of radiopharmaceuticals. The SMMs were correlated with histopathologic findings. Results: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The number of true positive, true negative, false positive, and false negative cases of ^99mTc-tetrofosmin SMM were 31, 10, 5, and 2, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of ^99mTc-tetrofosmin SMM were 93.9, 66.7, 86.1 and 73.3%, respectively. The number of true positive, true negative, false positive, and false negative cases of ^99mTc-MIBI SMM was 29, 10, 5, and 4, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of ^99mTc-MIBI SMM were 87.8, 66.7, 85.3 and 73.3%, respectively. In assessment of axillary lymph node involvement, ^99mTc tetrofosmin SMM demonstrated 31.8, 100, 100, and 42.3% sensitivity, specificity, positive and negative predictive values, respectively. The sensitivity and specificity of ^99mTc-MIBI SMM was 22.7 and 100%. Positive and negative predictive values were 100 and 39.3%, respectively. One patient was false negative in both ^99mTc-MIBI and ^99mTc-tetrofosmin SMMs with a tumor size of 0.5 cm. Conclusion:^99mTc-tetrofosmin and ^99mTc-MIBI SMMs were noninvasive and useful in the detection of primary breast cancer and ^99mTc tetrofosmin was comparable to ^99mTc-MIBI in the detection of primary breast cancer. However, both radiopharmaceuticals had limited values in the assessment of axillary lymph node involvement.

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“…In only four of the cited studies applied doses were below the recommended minimal dose of 740 MBq, in none of the studies, higher doses as recommended were applied (1,110 MBq). [47] Europe Turkey 740 Becherer [48] Europe Austria 630-740 Buscombe [49] Europe UK 740 Buscombe [50] Europe UK 740 Cwikla [51] Europe UK 740 Cwikla [52] Europe UK 740 Cwikla [53] Europe UK 740 Fondrinier [54] Europe France 740 Helbich [55] Europe Austria 629-740 Imbriaco [56] Europe Italy 555 Maffioli [57] Europe Italy 740 Marshall [58] Europe UK 750 Mathieu [59] Europe Belgium 740 Maublant [60] Europe France 740 Moretti [19] Europe France 500 Myslivecek [61] Europe Czech Republic 740 Palmedo [62] Europe Germany 740 Palmedo [63] Europe Germany 740 Papantoniou [64] Europe Greece 925-1,110 Prats [65] Europe Spain 740 Prats [66] Europe Spain 740 Sanidas [67] Europe Greece 740 Tiling [68] Europe Germany 740 Tiling [69] Europe Germany 740 Uriarte [70] Europe Spain 740 Chen [71] Asia China 740 Kao [72] Asia Taiwan 740 Kim [73] Asia South Korea 750 Kim [74] Asia South Korea 925 Kim [75] Asia South Korea 750 Tc-Sestamibi Scintimammography…”

Section: Tracer Injection Dosage and Administration 99mmentioning

confidence: 99%

99mTc-Sestamibi Scintimammography

Bucerius

2011

99mTc-Sestamibi

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From an anatomical point of view, the mammary gland is part of the female secondary sexual characteristics. The primary biological function of the mammary glands is the feeding of infants with breast milk. The mammary glands belong to the major glands of the cutis (glandulae cutis) and develop from epithelial cones, which grow in the surrounding connective tissue. Initially, the mammary glands are established in the same way in both genders.The female mammary glands are located on the major and minor pectoral muscles (M. pectoralis major, M. pectoralis minor) between the third and the seventh rib and between the sternal-and axillary line. The arterial blood supply of the mammary glands is provided by vascular branches (R. mammarii mediales and laterales) of the internal and lateral thoracic arteries (A. thoracica interna, A. thoracica lateralis) as well as by branches (R. preforantes and R. mammarii laterales) of the anterior and posterior intercostal arteries (Aa. intercostales anterior and posterior). The venous drain follows from superficial veins into the lateral and internal thoracic veins (Vv. thoracica lateralis and interna). The mammary glands are characterized by numerous lymphatic vessels, which build a superficial and deep lymphatic mesh with several directions of lymphatic drainage. From a clinical point of view, the main and most important lymphatic drainage reaches the axillary lymph nodes. Additional lymphatic drains flow off to the cervical lymph nodes superior to the clavicles and via the interpectoral lymphatic nodes (N. lymphatici interpectorales) between the pectoral muscles to the axillary lymph nodes, via the parasternal lymph nodes (N. lymphatici parasternales) along the internal thorac vein, and via the

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99Tcm-MIBI scintimammography in the evaluation of breast lesions and axillary involvement

Cited by 31 publications

References 0 publications

Breast-specific gamma imaging as an adjunct modality for the diagnosis of invasive breast cancer with correlation to tumour size and grade

Breast-specific gamma imaging as an adjunct modality for the diagnosis of invasive breast cancer with correlation to tumour size and grade

Technetium-99m-Tetrofosmin Scintimammography in Suspected Breast Cancer Patients: A Comparison with Technetium-99m-MIBI

99mTc-Sestamibi Scintimammography

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