title: Diagnostic value of 99mTc-methylene diphosphonate and 99mTc-pentavalent DMSA compared with 99mTc-sestamibi for palpable breast lesions.
abstract: Different radiopharmaceuticals have been used to detect breast cancer. Among them, sestamibi has been extensively studied and has come to have a well-recognized role in the evaluation of palpable breast lesions. The goal of this study was to compare the diagnostic value of 99mTc-labeled compounds, such as methylene diphosphonate (MDP) and pentavalent dimercaptosuccinic acid (DMSA-V), with sestamibi for palpable breast lesions, in the scope of a multicenter trial sponsored by the International Atomic Energy Agency.
  
  
  METHODS
  Patients from 7 countries were included: 47 women (mean age, 54 +/- 13 y) examined with MDP and sestamibi and 111 women (mean age, 55 +/- 12 y) examined with DMSA-V and sestamibi. Cancer was diagnosed in 41 of 49 lesions from the MDP group and in 78 of 113 lesions from the DMSA-V group. Axillary lymph node involvement was observed in 18 of 30 patients from the first group and in 27 of 53 patients from the second group. Prone scintimammography was performed using a dose of 740 MBq of each tracer, and diagnostic values were calculated from a masked interpretation of scans.
  
  
  RESULTS
  In the first group, the sensitivity for sestamibi and MDP studies was 82.9% and 65.9%, respectively, with a specificity of 87.5% and 50%, respectively. In the second group, the sensitivity for sestamibi and DMSA-V studies was 87.2% and 65.4%, respectively, with a specificity of 77.1% and 74.3%, respectively. Regarding axillary involvement, the sensitivity was 33.3% for sestamibi in both groups, whereas the values for MDP and DMSA-V were 16.7% and 7.4%, respectively. In contrast, the specificity for sestamibi was 83.3% and 92.3% for the first and second groups, respectively, and the specificity for MDP and DMSA-V was 91.7% and 100%, respectively.
  
  
  CONCLUSIONS
  Sestamibi is the most adequate alternative among the mentioned 99mTc-labeled radiopharmaceuticals for the evaluation of palpable breast lesions.
authors.affiliation: Nuclear Medicine Centre, University of Chile, Santiago, Chile. tmassardo@ns.hospital.uchile.cl
authors.forename: Teresa
authors.initials: T
authors.lastname: Massardo
authors.forename: Omar
authors.initials: O
authors.lastname: Alonso
authors.forename: Levent
authors.initials: L
authors.lastname: Kabasakal
authors.forename: Augusto
authors.initials: A
authors.lastname: Llamas-Olier
authors.forename: Uma Ravi
authors.initials: UR
authors.lastname: Shankar
authors.forename: Huiqing
authors.initials: H
authors.lastname: Zhu
authors.forename: Lucía
authors.initials: L
authors.lastname: Delgado
authors.forename: Patricio
authors.initials: P
authors.lastname: González
authors.forename: Fernando
authors.initials: F
authors.lastname: Mut
authors.forename: Ajit K
authors.initials: AK
authors.lastname: Padhy
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D013669:Technetium Tc 99m Medronate; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D017256:Technetium Tc 99m Sestamibi; D013669:Technetium Tc 99m Medronate