title: [Tc-99m]-sestamibi uptake and washout in locally advanced breast cancer are correlated with tumor blood flow.
abstract: OBJECTIVE
  To determine the influence of breast tumor blood flow on MIBI kinetics, we compared MIBI uptake and washout to [O-15]-water PET estimates of blood flow in patients with locally advanced breast cancer.
  
  
  METHODS
  Prior to therapy, 37 patients underwent MIBI and [O-15]-water PET imaging; 22/37 also had MIBI washout analysis. Twenty-five patients underwent serial imaging over the course of chemotherapy.
  
  
  RESULTS
  MIBI uptake and blood flow had a significant positive correlation pre-therapy. The change in MIBI uptake over the course of therapy also correlated with the change in blood flow. The half-time of MIBI washout inversely correlated with blood flow, indicating faster MIBI washout with higher blood flow.
  
  
  CONCLUSIONS
  Blood flow strongly influences early MIBI uptake and can be a factor affecting the rate of MIBI washout in breast tumors. We present a model of MIBI kinetics in tumors which forms a hypothesis for further mechanistic studies of MIBI uptake and washout in breast cancer.
authors.affiliation: Division of Nuclear Medicine, University of Washington, Seattle, WA, USA. dam@u.washington.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Mankoff
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Dunnwald
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gralow
authors.forename: Georgiana K
authors.initials: GK
authors.lastname: Ellis
authors.forename: Erin K
authors.initials: EK
authors.lastname: Schubert
authors.forename: Aaron W
authors.initials: AW
authors.lastname: Charlop
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Tseng
authors.forename: Kristine J
authors.initials: KJ
authors.lastname: Rinn
authors.forename: Robert B
authors.initials: RB
authors.lastname: Livingston
mesh_terms: D001783:Blood Flow Velocity; D001943:Breast Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008954:Models, Biological; D010104:Oxygen Radioisotopes / Q000493:pharmacokinetics; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics*; D014867:Water / Q000378:metabolism
chemical_list: D010104:Oxygen Radioisotopes; D019275:Radiopharmaceuticals; D014867:Water; D017256:Technetium Tc 99m Sestamibi