title: Value of 99m-Tc MIBI and 99m-Tc(V) DMSA scintigraphy in evaluation of breast mass lesions.
abstract: Among several investigative methods currently undergoing evaluation for the differentiation of biological features of breast mass lesions, mammoscintigraphy with different radiopharmaceuticals appears promising. This study evaluated the efficacy of 99m-Tc MIBI and 99m-Tc(V) DMSA mammoscintigraphy in the detection of malignant focal breast lesions. Mammography, ultrasonography, 99m-Tc MIBI and 99m-Tc(V) DMSA mammoscintigraphy were performed in 51 women with palpable breast mass lesions. Following surgical removal of the abnormalities, histological examination revealed 40 malignant and 11 benign breast mass lesions. In mammoscintigraphy, early (5 minute p.i. of MIBI, 2 hours p.i. of DMSA) and late (2 hours p.i. of MIBI and 5 hours p.i. of DMSA) planar images of the breast and the axillary regions were evaluated visually and quantitatively. The efficacy of the methods was assessed via ROC curves and variance analysis. The visual scores and the quantitative T/NT values with MIBI demonstrated a significant difference between malignant and benign breast mass lesions. A significant difference was also found as concerns the grade of malignancy from the MIBI accumulation. The late MIBI images seemed optimal. The DMSA values indicated no relationship with the breast lesion malignancy. In the detection of metastatic lymph node involvement the sensitivity and specificity with mammography and ultrasonography were 57% and 85%, with MIBI 53% and 81%, and with DMSA 53% and 95%, respectively. It is concluded that MIBI (2 hours p.i.) mammoscintigraphy is a useful and simple method for differentiation of malignant breast abnormalities from benign lesions and for determination of the grade of malignancy. DMSA mammoscintigraphy appears superior to MIBI only in the detection of axillary lymph node metastases.
authors.affiliation: Department of Nuclear Medicine, Albert Szent-Györgyi Medical University, Szeged, Hungary.
authors.forename: E
authors.initials: E
authors.lastname: Ambrus
authors.forename: M
authors.initials: M
authors.lastname: Rajtár
authors.forename: K
authors.initials: K
authors.lastname: Ormándi
authors.forename: T
authors.initials: T
authors.lastname: Séra
authors.forename: A
authors.initials: A
authors.lastname: Tószegi
authors.forename: J
authors.initials: J
authors.lastname: Láng
authors.forename: L
authors.initials: L
authors.lastname: Pávics
authors.forename: L
authors.initials: L
authors.lastname: Csernay
mesh_terms: D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D017256:Technetium Tc 99m Sestamibi; D016217:Ultrasonography, Mammary
chemical_list: D015609:Organotechnetium Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D017256:Technetium Tc 99m Sestamibi; D004113:Succimer