^99Tc^m-MIBI显像检测乳腺癌P-糖蛋白

探讨了乳腺癌多药耐药的主要机制和^99Tc^m-MIBI SPECT检测P-糖蛋白在多药耐药中的研究进展。作为一种功能显像技术，^99Tc^m-MIBI SPECT能够无创伤性检测乳腺癌多药耐药，为临床治疗提供参考。     

99Tcm-MIBI显像检测乳腺癌多药耐药

探讨了乳腺癌组织的多药耐药现象的主要机制及P-糖蛋白(P-gp)、胎盘型谷胱甘肽硫转移酶(GST-π)与~(99)Tc~m-MIBI显像的关系。尽管文献报道的实验结果不尽相同，但作为一种功能显像技术，~(99)TC~m-MIBI SPECT显像能够用来研究乳腺癌细胞P-gp的表达，可以在体外无创性检测乳腺癌多药耐药，为指导乳腺癌的治疗提供参考。     

99Tcm-MIBI显像对肿瘤多药耐药检测的应用

MDR(多药耐药)是目前肿瘤化疗失败的主要原因,对MDR的检测可以帮助化疗决策的制定,从而使肿瘤患者得到更有效的治疗。99Tcm-MIBI(99Tcm-甲氧基异丁基异腈)是mdr1基因编码的P-gp(P-糖蛋白)和MRP(多药耐药相关蛋白)的转运底物,肿瘤细胞内99Tcm-MIBI摄取减低表明其P-gp的高表达,并与MRP的表达相关。因此,99Tcm-MIBI显像可在治疗前预测对化疗的反应,并为选择更有效的化疗策略提供依据。99m     

99Tcm-MIBI用于乳腺癌诊断的评价

99Tcm-MIBI(9Tcm-甲氧基异丁基异腈)用于乳腺癌原发病灶诊断具有较高的灵敏度、特异性和准确率，与其他检测技术的对比研究显示其具有良好的应用前景，与其他检测技术联合应用可进一步提高诊断的准确性。     

99Tcm-MIBI显像在头颈部恶性肿瘤中的应用

99Tcm-MIBI(99Tcm-sestamibi)作为亲肿瘤显像剂,对头颈部恶性肿瘤及其颈部淋巴结转移、邻近颅骨受累的诊断有较高的灵敏度、特异性和准确性,在头颈部肿瘤的诊断和分期等方面有良好的应用前景.     

恶性骨肿瘤多药耐药的99Tcm-MIBI体层显像研究

大多数肿瘤都有多药耐药-1(MDR-1)基因的过度表达,其表达产物P-糖蛋白(P-gp)在肿瘤的耐药机制中起着关键作用,对P-gp表达的预测在化疗中至关重要,99Tcm-甲氧基异丁基异腈(99Tcm-MIBI)转运分析可作为探测低水平的P-gp表达和定量评价调节转运的敏感指标,指导应用调节剂改善化疗效果.     

99Tcm-甲氧基异丁基异腈显像在白血病中的应用价值

白血病是一类造血干细胞克隆性恶性疾病,99Tcm-甲氧基异丁基异腈(99Tcm-MIBI),作为一种肿瘤阳性显像剂,是诊断白血病的一种重要检查手段,特别是在探测白血病微小病灶、监测诱导化疗后的复发和检测白血病多药耐药性方面有重要作用.99Tcm-MIBI显像作为一种无创伤性的全身骨髓检查方法,对白血病的临床诊断有重要价值.     

^99Tc^m—MIBI显像检测乳腺癌多药耐药

探讨了乳腺癌组织的多药耐药现象的主要机制及P－糖蛋白（P－gp）、胎盘型谷胱甘肽硫转移酶（GST－π）与^99Tc^m－MIBI显像的关系。尽管献报道的实验结果不尽相同，但作为一种功能显像技术，^99Tc^m－MIBI SPECT显像能够用来研究乳腺癌细胞P－gp的表达，可以在体外无创性检测乳腺癌多药耐药，为指导乳腺癌的治疗提供参考。     

99Tcm-tetrofosmin在乳腺癌及其转移灶显像中的应用

99Tcm-tetrofosmin作为亲肿瘤显像剂,对乳腺癌原发病灶和腋窝淋巴结转移的诊断有良好的灵敏度、特异性和准确率,可应用于乳腺癌全身骨转移和术后复发的诊断,其应用于乳腺癌前哨淋巴结转移的诊断、作为P-糖蛋白功能显像剂和三维立体定位引导孔针型活检等领域有着良好的发展前景.99Tcm-tetrofosmin乳腺癌及转移灶显像可与其他乳腺癌检查方法相结合提高乳腺癌诊断的准确率.     

^99Tc^m—MIBI显像对肿瘤多药耐药检测的应用

MDR（多药耐药）是目前肿瘤化疗失败的主要原因，对MDR的检测可以帮助化疗决策的制定，从而使肿瘤患得到更有效的治疗，^99Tc^m-MIBI^99Tc^m-甲氧基异丁基甲腈）是mdr1基因编码的P-gp(P-糖蛋白）和MRP（多药耐药相关蛋白）的转运底物，肿瘤细胞内^99Tc^m-MIBI摄取减低表明其P-gp的高表达，并与MRP的表达相关，因此，^99Tc^m-MIBI显像可在治疗前预测对化疗的反应，并为选择更有效的化疗策略提供依据。     

99Tcm-MIBI scintimammography for the detection of breast malignancies: the contribution of the count ratio to specificity.

We evaluated the efficacy of 99Tcm-sestamibi (MIBI) scintimammography for the detection of breast cancer in 332 patients. Two hundred and seven scans were confirmed by histological or cytological results; the other patients were examined because they belonged to high-risk groups or had dense fibroglandular breasts. Of 207 patients with histological confirmation, 112 positive studies were obtained: 86 true-positive and 26 false-positive. Scintimammography was negative in 95 patients: 88 true-negative and seven false-negative. Six of seven false-negative results were obtained in patients with impalpable tumours. The sensitivity, specificity, positive and negative predictive values were 92.5%, 77.2%, 76.8% and 92.6% respectively. The overall accuracy was 84.1%. To identify false-positive results, the count ratio of the target lesion to the contralateral normal area on 38 true-positive scans and in 26 false-positive examinations was calculated from the region of interest drawn on the 99Tcm-MIBI scan (L/N ratio). A significantly higher ratio was found for the true-positive scans (1.583 +/- 0.501 vs 1.246 +/- 0.213; P = 0.0002). In conclusion, 99Tcm-MIBI scintimammography is a sensitive and accurate method for the detection of breast malignancies.     

Mammography and 99mTc-MIBI scintimammography in suspected breast cancer.

The aim of this work has been to evaluate whether a diagnostic protocol based on the joint use of mammography and 99mTc-methoxyisobutyl isonitrile (MIBI) scintimammography is capable of reducing the number of biopsies required in patients with suspected breast cancer. METHODS: We performed prone scintimammography in 90 patients with suspected breast cancer, involving 97 lesions. In all patients, the diagnosis was established by way of biopsy. On mammography, we evaluated the degree of suspicion of malignancy and the size of the lesion (smaller or larger than 1 cm in diameter). RESULTS: The results of only 41 of the biopsies indicated malignancy. On mammography, 20 lesions (of which 1 was breast cancer) were considered to be of low suspicion of malignancy, 31 (of which 4 were breast cancer) as indeterminate and 46 (of which 36 were breast cancer) as high. Fourteen lesions (2 low probability, 2 indeterminate and 10 high) were smaller than 1 cm, whereas 83 (18 low probability, 29 indeterminate and 36 high) were larger. The sensitivity, specificity, positive predictive value and negative predictive value of scintimammography were 85%, 79%, 74% and 88%, respectively. Scintimammography was positive in all cases of breast cancer that initially had a low or indeterminate suspicion of malignancy according to mammography, as well as in 30 cases of breast cancer that initially were highly suspicious. Six false-negative scintimammography studies were obtained in lesions with a high suspicion of malignancy. CONCLUSION: We propose a diagnostic protocol with a biopsy performed on lesions that have a high suspicion of malignancy as well as those with low or indeterminate suspicion that are smaller than 1 cm or with positive scintimammography results. This would have reduced the total number of biopsies performed by 34%. More importantly, there would have been a 65% reduction in number of biopsies performed in the low and indeterminate mammographic suspicion groups. All 41 cases of breast cancer would have been detected.     

Primary breast cancer imaging with technetium-99m sestamibi and its relation with P-glycoprotein overexpression

The aim of this preliminary study was to evaluate retrospectively sestamibi scintigraphy in relation to the presence of the 170-kDa P-glycoprotein (Pgp), which represents an expression of multidrug resistance in patients with primary breast cancer. Fifteen women (age range 37–76 years) were referred for technetium-99m sestamibi scintigraphy because of suspicious breast lesions detected by mammography and ultrasonography, and subsequently assessed by fine-needle aspiration. Scintigraphy was performed 30 min following the injection of 500 MBq^99mTc-sestamibi. Three planar anterior and oblique images were obtained with the patient in the supine position. Excised tumours were assessed for cytosolic CA 15.3, oestrogen (OR) and progesterone (PR) receptors and c-erb B2neu oncogene. Pathology revealed that only 13 of the 15 patients had malignant tumours. The two benign tumours were sestamibi-negative and Pgp-positive. Sestamibi scintigraphy was positive in 10 of the 13 malignant lesions (including nine of ten infiltrating ductal carcinomas). Two of the three lesions with false-negative scintigraphy were Pgp-negative; in one of these cases histology revealed an invasive lobular carcinoma and in the other, mucinous adenocarcinoma. The third false-negative lesion was a Pgp-positive infiltrating ductal carcinoma which was c-erb B2neu-negative but CA 15.3-, OR- and PR-positive. This preliminary study confirms that the resistance to chemotherapy which may occur in patients with primary breast cancer can be a cause of negative sestamibi scintigraphy.     

Initial evaluation of breast cancer using Tc-99m sestamibi scintimammography

AIM: Aim of the study was to elaborate on the diagnostic role of Tc-99m sestamibi scintimammography (SMM) in the initial diagnosis of breast cancer, partially in comparison to MRI. The study presents an update of previously published data. MATERIALS AND METHODS: Out of a total of 464 scintimammograms findings of 252 studies were correlated with the histopathologic outcome. A subgroup of 68 patients with indeterminate preliminary diagnosis underwent additional MRI. SMM and MRI findings were correlated to the final hisopathological outcome. RESULTS: Overall sensitivity and specificity for SMM were 84 and 85%, respectively. Depending on tumor size sensitivity ranged from 60% for stage pT1a,b carcinomas to 94% stage pT1c or higher. In the subgroup with indeterminate preliminary diagnosis sensitivity of SMM decreased to 76% which was lower as compared to MRI (84%). Specificity of SMM was 86% in this subgroup which was evidently higher as compared to MRI (51%). CONCLUSION: SMM has severe limitations in the diagnosis of small carcinoma and therefore should not be used for breast cancer screening. SMM can be used to further evaluate indeterminate or probably benign mammographic findings, especially when conventional mammography is inconclusive due to dense breast tissue.     

A comparison of 99Tcm-MDP and 99Tcm-MIBI in the detection of breast cancer

In this study, we made an intra-individual comparison of the uptake of 99Tcm-MDP and 99Tcm-MIBI in breast cancer. Twenty women with large breast masses (one dimension > or = 3 cm on mammography) underwent SPET in the supine position with both agents. All transverse sections demonstrating tumour activity were added together and the net (total) tumour uptake in a region of interest was compared to that of surrounding tissue activity (background). We also evaluated maximum tumour uptake versus background activity. Tumour uptake was observed in all examinations. In contrast to MIBI, eight MDP examinations showed increased uptake in normal breast parenchyma in addition to tumour uptake. There was no significant difference in net tumour uptake between the two tracers and non-parenchymal (indifferent) background activity, but the maximum tumour activity of MIBI was significantly higher than that of MDP. In the eight MDP examinations with parenchymal activity, mammograms were required to identify tumour uptake correctly. In conclusion, MDP may provide similar images to MIBI in postmenopausal women not receiving hormone replacement therapy. For other patients, MIBI gives better tumour depiction.