Nuclear imaging of the breast: Translating achievements in instrumentation into clinical use

Abstract

Approaches to imaging the breast with nuclear medicine and/or molecular imaging methods have been under investigation since the late 1980s when a technique called scintimammography was first introduced. This review charts the progress of nuclear imaging of the breast over the last 20 years, covering the development of newer techniques such as breast specific gamma imaging, molecular breast imaging, and positron emission mammography. Key issues critical to the adoption of these technologies in the clinical environment are discussed, including the current status of clinical studies, the efforts at reducing the radiation dose from procedures associated with these technologies, and the relevant radiopharmaceuticals that are available or under development. The necessary steps required to move these technologies from bench to bedside are also discussed.

Non-rigid registration of serial dedicated breast CT, longitudinal dedicated breast CT and PET/CT images using the diffeomorphic demons method

“…The need for such tools arises because inter-scan patient motion or repositioning may lead to different orientations of the inherently non-rigid breast tissue in the field of view of the scanner. Image registration may also play an important role for dedicated breast PET/CT and SPECT/CT, where early monitoring of response to NAC is the clinical goal [9–11]. In this case software-based alignment of the anatomical images from the bCT component in a longitudinal setting may enable rapid region-of-interest (ROI)-based comparisons for the PET or SPECT images.…”

A Molecular Approach to Breast Imaging

“…The potential for molecular imaging of breast cancer was discovered serendipitously in the 1970s when single-photonemitting radiopharmaceuticals administered for bone and cardiac imaging also localized within breast malignancies (1). Further investigations of planar scintigraphy and SPECT of the breast, termed scintimammography, have focused primarily on 99m Tc-methoxyisobutylisonitrile ( 99m Tc-sestamibi).…”

Direct-Conversion Molecular Breast Imaging of Invasive Breast Cancer: Imaging Features, Extent of Invasive Disease, and Comparison Between Invasive Ductal and Lobular Histology

“…Molecular breast imaging usually refers to a configuration of two detectors made of a semiconductor cadmium zinc telluride that directly converts gamma ray energy into electronic signals [5]. The term "direct-conversion molecular breast imaging" has been introduced to specify the dualhead semiconductor configuration [6,7].…”

“…Molecular breast imaging usually refers to a configuration of two detectors made of a semiconductor cadmium zinc telluride that directly converts gamma ray energy into electronic signals [5]. The term "direct-conversion molecular breast imaging" has been introduced to specify the dualhead semiconductor configuration [6,7].Multiple possible uses for breast gamma imaging are being actively investigated, including screening [8,9], diagnostic problem solving [1,5], evaluation of extent of disease and contralateral screening for patients with newly diagnosed breast cancer [10][11][12], and prediction and evaluation of response to neoadjuvant chemotherapy [6,13]. In the screening setting, adjunctive molecular breast imaging in combination with…”