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1.
J. B. Cwikla J. R. Buscombe R. V. Barlow S. M. Kelleher S. P. Parbhoo J. Crow A. Deery A. L. Jones A. J. W. Hilson 《European journal of nuclear medicine and molecular imaging》1997,24(9):1175-1178
Technetium-99m sestamibi scintimammography has been used primarily in the diagnosis of breast cancer. It has also been suggested that this technique could be used to monitor response to chemotherapy and possibly to predict those patients in whom no response can be expected. An initial study was performed in nine patients with primary breast cancer. All patients underwent prone lateral and anterior99mTc-sestamibi imaging at diagnosis and 4–7 months later, after they had received cytotoxic chemotherapy. The uptake of99mTc-sestamibi in the breast was compared with that in normal surrounding breast tissue and this ratio was expressed as the target to background ratio. In all patients treated there was a reduction in uptake of99mTc-sestamibi after treatment, such that whilst all the tumours could be seen before treatment, only three were visible following chemotherapy. There was a significant fall in the mean target to background ratio of the patients undergoing chemotherapy: the tumour to background ratio was 2.48 before chemotherapy and 1.40 after treatment (P<0.001, paired Student'st test). This fall in tumour activity was observed both in those patients in whom a clinical response was seen and in the two patients in whom the tumour enlarged despite chemotherapy. It appears that the reduced uptake of99mTc-sestamibi seen after chemotherapy may be a non-specific change and therefore may not be predictive of the clinical response to treatment. 相似文献
2.
W. W. M. Lam W. T. Yang Y. L. Chan I. E. T. Stewart C. Metreweli W. King 《European journal of nuclear medicine and molecular imaging》1996,23(5):498-503
Axillary lymph node status is important in the staging of breast carcinoma. To evaluate the accuracy of technetium-99m sestamibi breast scintigraphy in detecting metastatic axillary lymph nodes as compared with other accepted imaging modalities, we performed99mTc-sestamibi breast scintigraphy, conventional mammography and ultrasound in 36 patients with primary untreated breast carcinoma. With histopathology as the gold standard,99mTc-sestamibi breast scintigraphy was found to yield true-positive results in 7 of 11 cases (64%) of axillary lymph node metastases and true-negative results in 18 of 20 cases (90%); it has an accuracy of 81%, a positive predictive value of 77.8% and a negative predictive value of 81.8%. 相似文献
3.
Scintimammography with technetium-99m methoxyisobutylisonitrile: results of a prospective European multicentre trial 总被引:2,自引:0,他引:2
H. Palmedo H. J. Biersack S. Lastoria J. Maublant E. Prats H. E. Stegner P. Bourgeois R. Hustinx A. J. W. Hilson A. Bischof-Delaloye 《European journal of nuclear medicine and molecular imaging》1998,25(4):375-385
The aim of the trial was to determine the diagnostic accuracy of scintimmammography with technetium-99m methoxyisobutylisonitrile
(99mTc-MIBI) in the detection of primary breast cancer and to verify its clinical usefulness. A total of 246 patients with a suspicious
breast mass or positive mammogram were included in this prospective European multicentre trial. At 5 min and 60 min (optional)
p.i. two lateral prone images were acquired for 10 min each; 30 min p.i. one anterior image was acquired for 10 min. There
were 253 lesions (195 palpable and 58 non-palpable), in respect of which histology revealed 165 cancers and 88 benign lesions.
Institutional and blinded read results were correlated to core laboratory histopathology results obtained during excisional
biopsy. Diagnostic accuracy for the detection of breast cancer was calculated per lesion. The overall sensitivity and specificity
of blinded read scintimammography were 71% and 69%, respectively. For palpable lesions, the sensitivity of blinded read and
institutional read scintimammography was 83% and 91%, respectively. Sensitivity was not dependent on the density of the breast
tissue. Invasive ductal and invasive lobular cancers showed similar sensitivity. The sensitivity and specificity of mammography
were 91% and 42%, respectively, and did not depend on the tumour size. In 60% of false-negative mammograms, 99mTc-MIBI was able to diagnose malignancy (true-positive). High-quality imaging with 99mTc-MIBI has a high diagnostic accuracy for the detection of primary breast cancer. Used as a complementary method, scintimammography
with 99mTc-MIBI can help to diagnose breast cancer at an earlier stage in patients with dense breasts.
Received 11 October and in revised form 12 December 1997 相似文献
4.
Hitoya Ohta Tomoo Komibuchi Toshihiro Nishio Toshiyuki Kitai Shunji Yamamoto Minoru Ukikusa Hiroji Awane Kunikatsu Irie Masayuki Shintaku 《Annals of nuclear medicine》1997,11(1):37-39
We presented two cases of phyllodes tumor of the breast examined by99mTc-sestamibi (MIBI) two-phase scintimammography. In the case with malignant phyllodes tumor,99mTc-MIBI accumulation was recognized on both early and delayed images. In the case with benign phyllodes tumor, however,99mTc-MIBI accumulation was recognized on only the early image.99mTc-MIBI delayed imaging may have the potential to distinguish between benign and malignant phyllodes tumors. 相似文献
5.
In vivo detection of multidrug-resistant (MDR1) phenotype by technetium-99m sestamibi scan in untreated breast cancer patients 总被引:6,自引:3,他引:3
Silvana Del Vecchio Andrea Ciarmiello Maria I. Potena Maria V. Carriero Ciro Mainolfi Gerardo Botti Renato Thomas Maria Cerra Giuseppe D'Aiuto Takashi Tsuruo Marco Salvatore 《European journal of nuclear medicine and molecular imaging》1997,24(2):150-159
Technetium-99m sestamibi is a transport substrate recognised by the multidrug-resistant P-glycoprotein (Pgp). To test whether99mTc-sestamibi efflux is enhanced in breast carcinomas overexpressing Pgp, we determined the efflux rates of99mTc-sestamibi and Pgp levels in tumours from 30 patients with untreated breast carcinoma. Patients were intravenously injected
with 740 MBq of99mTc-sestamibi and underwent a 15-min dynamic study followed by the acquisition of static planar images at 0.5, 1, 2 and 4 h.
Tumour specimens were obtained from each patient 24 h after99mTc-sestamibi scan and Pgp levels were determined using125I-MRK16 monoclonal antibody and in vitro quantitative autoradiography. All breast carcinomas showed high uptake of99mTc-sestamibi and data from region of interest analysis on sequential images were fitted with a monoexponential function. The
efflux rates of99mTc-sestamibi, calculated from decay-corrected time-activity curves, ranged between 0.00121 and 0.01690 min−1 and were directly correlated with Pgp levels measured in the same tumours (r=0.62;P<0.001). Ten out of 30 breast carcinomas (33%) contained 5 times more Pgp than benign breast lesions and showed a mean concentration
of 5.73±1.63 pmol/g of tumour (group A). The remaining 20 breast carcinomas had a mean Pgp concentration of 1.29±0.64 pmol/g
(group B), equivalent to that found in benign breast lesions.99mTc-sestamibi efflux from tumours of group A was 2.7 times higher than that observed in tumours of group B (0.00686±0.00390
min−1 vs 0.00250±0.00090 min−1,P<0.001). The in vivo functional test with99mTc-sestamibi showed a sensitivity and a specificity of 80% and 95%, respectively. In conclusion, the efflux rate of99mTc-sestamibi may be used for the in vivo identification of the multidrug resistant (MDR1) phenotype in untreated breast cancer
patients. 相似文献
6.
F. Scopinaro O. Schillaci M. Scarpini P. L. Mingazzini L. Di Macio M. Banci R. Danieli M. Zerilli M. R. Limiti A. Centi Colella 《European journal of nuclear medicine and molecular imaging》1994,21(9):984-987
As recently shown, angiogenesis is the most reliable marker of breast cancer invasiveness. Unfortunately it must be assessed by immunohistochemistry on tissue specimens. We have used technetium-99m sestamibi, a marker of regional blood flow in other organs that often but not always images breast cancer, to assess the invasiveness of this tumour. Nineteen patients, ten with nodal metastases and nine without any metastases, were studied with 99mTc-sestamibi scintigraphy before operation. Angiogenesis was quantitatively assessed by immunohistochemical staining of endothelia for factor VIII. All the node-positive (N+) patients at surgical revision showed a positive 99mTc-sestamibi scan of the primary tumour and all the N-patients were negative. Nine out of ten N+ and sestamibi-positive tumours showed more than 135 microvessels/mm2 and one showed 99 microvessels/mm2; by contrast there were 71.6±12.1 microvessels/mm2 in the nine N- and sestamibi-negative tumours. Our study suggests that 99mTc-sestamibi is a marker of breast cancer invasiveness: its uptake is related to angiogenesis and, possibly, to oxidative metabolism of the tumour. 相似文献
7.
Breast cancer staging using technetium-99m sestamibi and indium-111 pentetreotide single-photon emission tomography 总被引:2,自引:0,他引:2
Arturo Chiti Roberto Agresti Lorenzo S. Maffioli Gorana Tomasic Giordano Savelli Flavio Crippa Silvana Pilotti Marco Greco Emilio Bombardieri 《European journal of nuclear medicine and molecular imaging》1997,24(2):192-196
We evaluated the clinical usefulness of single-photon emission tomography (SPET) with technetium-99m sestamibi and indium-111
pentetreotide in breast cancer staging. Fifteen patients with clinical and/or mammographic findings suggesting T1-2N0-1 breast
cancer were studied. SPET images were acquired 20 min after99mTc-sestamibi injection and 4 and 24 h after111In-pentetreotide injection. Patients underwent surgery the day after the later111In-pentetreotide acquisition. Pathological examination showed 16 tumours in the 15 patients, with one bilateral carcinoma.
The mean tumour diameter was 18.7 mm. Metastatic axillary involvement was found in 6/16 tumours, with a mean of five metastatic
nodes per axilla. Both tracers correctly identified 15/16 primary tumours and five of the six cases of metastatic axillary
node involvement. No difference between the tracers was observed in breast cancer staging.99mTc-sestamibi seems to be the better tracer in terms of physical characteristics, execution time and cost-effectiveness. Our
data suggest the future possibility of using nuclear medicine imaging to avoid axillary dissection in patients with T1 breast
cancer. 相似文献
8.
Isabel Uriarte Jose Manuel Carril Remedios Quirce Ceferino Gutiérrez-Mendiguchía Isabel Blanco Ignacio Banzo Alfonso Vega Ana Hernández 《European journal of nuclear medicine and molecular imaging》1998,25(5):491-496
The purpose of this study was to evaluate the contribution of technetium-99m methoxyisobutylisonitrile (MIBI) scintimammography
to the early diagnosis of breast cancer in 78 patients with non-palpable breast lesions detected by mammography. In all cases
biopsy was indicated and they were classified into three groups according to the mammographic findings: high (28), intermediate
(30) and low (20) mammographic probability of malignancy. Histological diagnosis confirmed 37 benign and 41 malignant lesions.
In the high-probability group 99mTc-MIBI scintimammography changed the four false-positives into true negatives at the expense of two false-negatives; in the
intermediate group it changed nine of the 17 false-positives into true-negatives at the expense of one false-negative, and
in the low-probability group it changed five of the 16 false-positives into true-negatives without false-negatives. Applying
scintimammography to patients included in the intermediate and low-probability groups together, 14 of the 33 mammographic
false-positives were changed into true-negatives with 1 false-negative; thus, 41% of the unnecessary biopsies would have been
avoided. When MIBI scintimammography was applied to the low-probability group, the negative predictive value was 100% and
the unnecessary biopsies would have been reduced by 31%.
Received 10 November 1997 and in revised form 19 January 1998 相似文献
9.
Hitoya Ohta Takuya Kosumi Toshiyuki Kitai Shunji Yamamoto Minoru Ukikusa Hiroji Awane Masayuki Shintaku 《Annals of nuclear medicine》1997,11(3):259-262
We presented three patients with bilateral breast tumors (one with breast cancers, one with breast cancer and fibroadenoma, and one with fibroadenomas) examined by99mTc-hexakis 2-methoxy-isobutylisonitrile (MIBI) scintimammography. In all cases99mTc-MIBI uptake was recognized only in the breast cancers.99mTc-MIBI scintimammography was useful in evaluating bilateral breast tumors since preoperative diagnosis is valuable in determining correct surgical treatment. 相似文献
10.
Leung JW 《Radiologic clinics of North America》2002,40(3):467-482
Digital mammography, PET, and sestamibi scintimammography are three new modalities in breast imaging. DM has advantages over film-screen mammography in image storage, retrieval, and processing and may lower the recall rate. Computer-aided detection may increase the sensitivity of mammographic screening without a substantial reduction in specificity. Whereas PET and sestambi scintimammography are not useful in breast cancer screening, PET may play a role in detecting nodal metastases and monitoring treatment response, and sestamibi scintimammography in selected cases may serve as an adjunct to conventional imaging. The cost-effectiveness of these new modalities remains to be evaluated, but all have the potential to significantly advance the diagnosis and management of women with breast cancer. 相似文献
11.
Francesco Scopinaro Roberto Pani Giuseppe De Vincentis Alessandro Soluri Rosanna Pellegrini Lucio M. Porfiri 《European journal of nuclear medicine and molecular imaging》1999,26(10):1279-1288
. The main disadvantage of technetium-99m methoxyisobutylisonitrile (MIBI) prone scintimammography is its limited sensitivity
for T1a and T1b cancers with a size of less than 1 cm. We have developed a high-resolution scintimammographic technique using
a gamma camera based on a new concept, namely a position-sensitive photo-multiplier tube. The field of view of this camera,
previously known as the SPEM (single photon emission mammography) camera, was 10 cm diameter. Scintimammographic images were
acquired in the axial view; each breast was compressed to a thickness of 3–6 cm, modal class 4 cm. When the compressed breast
was larger than the field of view, more than one study was performed in order to image the entire gland. Fifty-three patients
were studied with high-resolution-scintimammography (HRSM) and Anger camera prone scintimammography (ACPSM). HRSM was performed
70 min after i.v. administration of 740 Mbq of 99mTc-MIBI; ACPSM images were acquired 10 and 60 min following the injection. Early 10-min ACPSM images were only evaluated for
routine diagnostic purposes, while comparison was carried out between the 60-min ACPSM and 70-min HRSM images. At fine-needle
aspiration (FNA) and/or open biopsy, 31 patients showed cancer: 15 T1c, 11 T1b and 5 T1a. In T1a-T1b cancers, the sensitivity
of scintimammography was 50% with ACPSM and 81.2% with HRSM (P<0.01). Specificity was 86% with both techniques. HRSM is a promising new technique that improves the sensitivity of 99mTc-MIBI scintimammography in tumours sized less than 1 cm without apparently reducing its specificity. We are now working
on a larger field-of-view camera.
Received 10 February and in revised form 28 April 1999 相似文献
12.
Technetium-99m sestamibi imaging in paediatric neuroblastoma and ganglioneuroma and its relation to P-glycoprotein 总被引:1,自引:1,他引:0
Barbara De Moerloose Christophe Van de Wiele Catharina Dhooge Jan Philippé Frank Speleman Yves Benoit Geneviève Laureys Rudy A. Dierckx 《European journal of nuclear medicine and molecular imaging》1999,26(4):396-403
Imaging with technetium-99m sestamibi offers a non-invasive approach to detect the presence of functional P-glycoprotein
(Pgp), one of the major causes of multidrug resistance, in human malignancies. A clinical role for Pgp has been suggested
in the subpopulation of primary neuroblastoma without amplification of the proto-oncogene MYCN. We wanted to evaluate the
usefulness of 99mTc-sestamibi scintigraphy in the screening of neural crest tumours for the presence of Pgp. In ten children suffering from
MYCN-negative neuroblastoma, ganglioneuroblastoma or ganglioneuroma, 99mTc-sestamibi imaging was performed at initial diagnosis. All patients underwent planar imaging 20–30 min and 3.5–4 h after
intravenous injection of 740 MBq/1.73 m2
99mTc-sestamibi. Tumour to normal tissue ratios, as well as washout rates, were determined and compared with in vitro flow cytometric
analysis of Pgp expression and function. Pgp expression was analysed flow cytometrically with the monoclonal antibodies 4E3
and MRK16, and Pgp function was evaluated by means of rhodamine 123 uptake and efflux either in the absence or in the presence
of the Pgp inhibitor verapamil. In nine of ten patients, we found that the intratumoral 99mTc-sestamibi activity was comparable to the background activity, which might be suggestive of Pgp presence. This was confirmed
flow cytometrically in all but one patient. 99mTc-sestamibi enhancement was seen in the primary tumour and the bone marrow metastases of one of the ten patients, and this
result was concordant with a negative Pgp status. The findings presented suggest that 99mTc-sestamibi imaging results might correlate with the presence of functional Pgp in neural crest tumours without MYCN amplification.
Received 17 October and in revised form 13 December 1998 相似文献
13.
J B Cwikla J R Buscombe B Holloway S P Parbhoo T Davidson N McDermott A J Hilson 《Nuclear medicine communications》2001,22(12):1287-1293
Scintimammography with (99m)Tc-MIBI has been shown to be an effective adjunct to imaging of the breast with mammography. Uptake of (99m)Tc-MIBI is particularly high in sites of non-calcified cancer and ductal carcinoma in situ (DCIS), and as a consequence it may be possible to use this method of imaging in identifying multifocal or multicentric disease. The aim of this study was to evaluate the efficacy of preoperative scintimammography in the detection of multifocal and multicentric breast cancer and compare these results with mammography. A retrospective review was performed of 353 women imaged with (99m)Tc-MIBI as part of the clinical assessment of their suspected primary breast cancer. The results of the scintimammography and mammography were then compared with the final pathological diagnosis obtained after mastectomy in all patients. Histopathological assessments of breast tissue from mastectomy confirmed 40 women (12%) had multifocal (34) or multicentric (six) breast cancer. Scintimammography correctly identified 39 of these cancers and the multifocal or multicentric character of the cancer was identified in 22 (52%) of these patients. Anatomical imaging performed in all 40 patients including 25 with mammography alone, mammography and ultrasound in 11 cases and ultrasound alone in four patients. Anatomical imaging identified cancer to be present in 28 patients (70%) and the combination of mammography and ultrasound identified correctly that the cancer was multifocal or multicentric in eight patients (22%). In this study scintimammography was able to identify more cases of multifocal and multicentric cancer than mammography and/or ultrasound. In patients where pre-operative identification of multicentric or multifocal disease can alter treatment scintimammography may be a useful investigative tool. 相似文献
14.
Hirofumi Fum Kayoko Nakamura Atsushi Kubo Kohji Enomoto Tadashi Ikeda Tetsuro Kubota Shinjiro Wilson Matsuzaki Masaki Kitajima 《Annals of nuclear medicine》1998,12(6):307-312
The chemosensitivity of breast cancer is important for its management, but it is difficult to evaluate preoperatively. Tc-99m hexakis-2-methoxyisobutylisonitrile (MIBI) scintimammography has been reported to indicate the expression of P-glycoprotein, which is one factor concerned with multidrug resistance. We developed a chemosensitivity assay by using surgical specimens to investigate whether99mTc-MIBI scintimammography findings before the operation are related to chemosensitivity according to our assay. Fifteen patients with primary breast cancer were enrolled into the study. Early and delayed images were obtained at 10 and 120 minutes after intravenous injection of99mTc-MIBI, respectively. Regions of interest were placed on the tumors and the contralateral healthy breasts in each patient to estimate99mTc-MIBI uptake in the tumor, and retention indices were then calculated to assess the washout of99mTc-MIBI. Chemosensitivity assay was performed by incubating surgical specimens with anticancer agents such as doxorubicin, epirubicin, pinorubicin, mitomycin C, cisplatin and 5-fluorouracil.99mTc-MIBI washout on scintimammography was successfully related to inhibition ratios on chemosensitivity tests when compared with99mTc-MIBI uptake by the tumor. In particular, high correlation coefficients were obtained between the retention index of99mTc-MIBI and the inhibition ratios of doxorubicin (r = 0.75), epirubicin (r = 0.60) and pinorubicin (r = 0.62), but poor correlation was found for mitomycin C (r = 0.44) and cisplatin (r = 0.31). Our results indicate that the retention index of99mTc-MIBI is closely correlated to chemosensitivity to anthracyclines, suggesting that double-phase scintimammography allows preoperative prediction of chemosensitivity of breast cancer. 相似文献
15.
Danielsson R Sánchez-Crespo A Pegerfalk A Grabowska H Larsson SA Boné B Aspelin P 《European journal of nuclear medicine and molecular imaging》2003,30(5):662-666
The aim of this study was to investigate whether there is a correlation between (99m)Tc-sestamibi uptake and histological malignancy grade in breast carcinoma. Such a correlation could, prior to surgery and histopathological analysis, facilitate selection of patients who need adjuvant therapy. Ninety-six patients with mammographically determined lesions and/or a palpable tumour suspected for malignancy underwent (99m)Tc-sestamibi scintimammography prior to surgery. The final diagnosis was determined by histopathological examination. Benign lesions, cancer in situ and tumours located medially in the breast were excluded. Fifty-three invasive cancer lesions in 53 patients were finally included in the study. Planar scintigraphic breast imaging included two prone lateral projections and one anterior supine projection taken 10 min after injection of 700 MBq (99m)Tc-sestamibi. Focal (99m)Tc-sestamibi uptake in breast lesions was used as the scintigraphic criterion of abnormality. Tumour to background ratios were calculated with partial volume compensation, and histological malignancy grading was performed according to the Elston classification. A correlation was found between (99m)Tc-sestamibi uptake and histological malignancy grade in invasive breast carcinomas ( P相似文献
16.
Sanidas EE Koukouraki S Velidaki A Manios A Stathopoulos E De Bree E Kafousi M Kodogiannis E Karkavitsas N Tsiftsis DD 《Nuclear medicine communications》2003,24(3):291-296
Mammography is the screening test of choice for breast cancer. Its low specificity leads to a large number of unnecessary biopsies. Scintimammography, with either Tc-sestamibi (MIBI) or Tc-anti-carcinoembryonic antigen (CEA) Fab', has been proposed as a non-invasive test to lower the high false positive rate of mammography in certain patients. The two agents have not been compared, nor has their combined application been evaluated. We performed a prospective, non-randomized, open-label, single-centre study of 32 women with clinically and mammographically suspected breast cancer [Breast Imaging Reporting and Data System (BI-RADS, American College of Radiology) 4 or 5]. All patients underwent Tc-MIBI and Tc-anti-CEA Fab' scintimammography, and the results were correlated with histopathology. Overall, the accuracies for MIBI and CEA scans were 90.3% (28/31) and 77.4% (24/31), respectively. The probability of disease after mammography was 0.939+/-0.081 (95% confidence interval, CI). The post-mammography probabilities after positive MIBI or CEA scan were 0.965 and 0.960, respectively, and after negative MIBI or CEA scan 0.750 and 0.875, respectively. None of the above differences is significant. The post-test probability when both scans were positive (irrespective of which was performed first) was 0.977. It can be concluded that there are indications that scintimammography with Tc-MIBI is superior to that with Tc-anti-CEA Fab' when these tests are used as screening tests for breast cancer. However, mammography remains the screening test of choice for highly suspicious clinically palpable breast lesions. In this group of patients, the application of scintimammography with either Tc-MIBI or Tc-anti-CEA Fab' (alone or in combination) offers no additional advantage. 相似文献
17.
Scintimammography with technetium-99m tetrofosmin in the diagnosis of breast cancer and lymph node metastases 总被引:3,自引:0,他引:3
Luigi Mansi Pier Francesco Rambaldi Eugenio Procaccini Fernando Di Gregorio Adelina Laprovitera Biagio Pecori Walter Del Vecchio 《European journal of nuclear medicine and molecular imaging》1996,23(8):932-939
The aim of the study was to evaluate the possible role of scintimammography (SMM) with technetium-99m tetrofosmin in breast cancer. Thirty-three patients with breast disease and ten normal controls were included in the study. Planar scintigraphic images in supine anterior, prone lateral and lateral views, with the patient lying in lateral recumbency, were acquired. A qualitative analysis evaluating both breasts and lymph nodes was performed. All breast lesions were verified after surgery and/or by fine-needle aspiration. In 8 of the 33 patients, mammography was inconclusive because of mastectomy or dense breasts. For mammography, a sensitivity of 95.6%, a specificity of 66.7% and an accuracy of 89.6% were obtained. At SMM, 26 out of 28 malignant lesions (average size 2.8 cm, range 0.4–12 cm), including two recurrences, were detected with a 92.8% sensitivity, a 100% specificity and a 95.1% accuracy. The smallest detectable carcinoma measured 0.6 cm. Two false-negative results on SMM were found in a 0.4-cm intraductal carcinoma and in the only mucinous papillary carcinoma in our series. With regard to lymph node analysis, 11 out of 12 axillary metastases (sensitivity=91.6%) were detected. A false-positive result, yielding a specificity of 92.3% was also obtained. A metastatic involvement of the internal mammary chain was observed. No uptake was seen in 11 benign mammary lesions or at the level of the breast and axilla when neoplastic involvement was absent. In conclusion, SMM with99mTc-tetrofosmin is an effective technique for the evaluation of primary breast carcinomas, recurrences and lymph node metastases. 相似文献
18.
Scintimammography with dedicated breast camera detects and localizes occult carcinoma. 总被引:8,自引:0,他引:8
This study assessed the utility of scintimammography using a standard gamma-camera and a dedicated breast camera as an adjuvant to mammography and clinical examination. METHODS: The study population comprised 37 patients with dense breasts and a family or personal history of breast cancer. The subjects had no suggestive clinical or mammographic findings. After intravenous administration of (99m)Tc-sestamibi, the patients were imaged using a conventional gamma-camera and a dedicated breast camera that allowed breast compression during image acquisition. Images were interpreted independently by 2 reviewers. All patients with positive scintimammography findings underwent biopsy. RESULTS: Dedicated breast camera results were positive in 13.5% (5/37) of patients. Biopsy of these 5 patients yielded 3 carcinomas: an infiltrating lobular carcinoma, a ductal carcinoma in situ, and an infiltrating tubular carcinoma. These 3 carcinomas were undetectable by clinical breast examination or mammography, even on retrospective review. Only one of these, the tubular carcinoma, was readily detectable by the standard gamma-camera. CONCLUSION: Scintimammography using a dedicated breast camera may augment mammography and clinical breast examination for the subset of women who have dense breast tissue and are at high risk of breast cancer. 相似文献
19.
Purpose
We evaluated the efficacy of 99mTc-sestamibi SPECT/CT for planning minimally invasive parathyroidectomy (MIP), comparing with dual phase 99mTc-sestamibi scintigraphy, 99mTc-sestamibi SPECT and conventional imaging (US and CT).Methods
Thirty-one patients (M:F?=?10:21, range 35?C78?years old) who showed high serum parathyroid hormone (intact PTH) level were included. 99mTc-sestamibi scintigraphy was performed 15 and 150?min after injection of 99mTc-sestamibi (555?MBq), and 99mTc-sestamibi SPECT/CT was obtained just after the delayed scan. Comparison study between imaging modalities was done by patient-based and lesion location-based analysis. The location of the lesion was confirmed by the operative finding. An operation was performed in 24 patients. Seven patients had normal 99mTc-sestamibi SPECT/CT, and followed for more than 6?months after SPECT/CT.Results
Among 24 patients, parathyroid adenoma was detected in 19 patients and the other 5 had parathyroid hyperplasia (total 35 lesions). 99mTc-sestamibi scintigraphy detected abnormal uptake in 15 patients with 24 lesions. Conventional imaging identified abnormal findings in 17 patients with 27 lesions. SPECT detected abnormal findings in 18 patients with 27 lesions. SPECT/CT identified abnormal findings in 24 patients with 35 lesions. SPECT/CT demonstrated 100?% sensitivity in a patient-based analysis. SPECT/CT exhibited significantly better sensitivity than 99mTc-sestamibi scintigraphy, SPECT and conventional imaging (p?<?0.05). All lesion location was correctly identified to perform MIP. The final clinical diagnosis of 7 normal SPECT/CT patients was secondary hyperparathyroidism on 6?months follow-up.Conclusions
We correctly identified the precise location of parathyroid adenomas or hyperplasia by 99mTc-sestamibi SPECT/CT which was helpful to perform MIP. 相似文献20.
Douglas Howarth Robert Sillar David Clark Linda Lan 《European journal of nuclear medicine and molecular imaging》1999,26(11):1475-1481
The limit of detection of invasive carcinoma by scintimammography appears to be >10 mm, but not uncommonly smaller invasive
carcinoma is detected in the presence of pre-invasive carcinoma (carcinoma in situ). The aims of this study were to determine
whether a relationship exists between the presence of carcinoma in situ and the detection of invasive carcinoma using scintimammography,
and to further characterise the influence of lesion size and histopathological characteristics on the diagnostic accuracy
of scintimammography for the detection of invasive breast carcinoma. One hundred and seventeen patients were studied prospectively
by scintimammography, X-ray mammography and, where appropriate, breast ultrasound prior to excision biopsy of all suspicious
breast masses (n=123, 93% palpable). Thirty-five of these patients had a history of previous ipsilateral breast carcinoma. Sixteen percent
of biopsy specimens were benign. The remaining specimens were malignant or pre-malignant. The overall diagnostic sensitivity
of scintimammography was 84% and the specificity was 80%. The overall sensitivity and specificity for X-ray mammography (n=123), including those examinations combined with breast ultrasound (n=76), were 73% and 69%, respectively. The maximum size of the measured invasive carcinoma ranged from 5 to 80 mm (median 20
mm). Although the maximum size detected for invasive carcinoma in the presence of carcinoma in situ ranged from 3 to 40 mm
(median 20 mm), this difference was not statistically significant (P=1.10, t test). Seven cases of carcinoma in situ were not detected by scintimammography. The diagnostic sensitivity of scintimammography
for the detection of invasive carcinoma was 98% for lesions 16–25 mm, 91% for lesions 11–25 mm, 78% for lesions >25 mm and
55% for lesions <11 mm. Scintimammography may offer increased diagnostic accuracy for the detection of breast carcinoma, thereby
complementing anatomical imaging. This is particularly evident in technically difficult patients who have had previously treated
breast cancer. There appears to be no difference in the diagnostic sensitivity of scintimammography for the detection of invasive
carcinoma in the presence or absence of carcinoma in situ.
Received 12 April and in revised form 3 July 1999 相似文献