99m-Tc-MDP-Scintimammography in the evaluation of breast masses or tumor angiogenesis.
BACKGROUND
Vascular endothelial growth factor (VEGF) is a prognostic factor in breast cancer. One of the mechanisms of extra-skeletal uptake of Tc-99m-methylenediphosphonate (MDP) is suggested to be tumor vascularity. We studied the correlation between MDP uptake and VEGF and compared the diagnostic accuracy of mammography versus MDP-scintimammography (MDP-S).


METHODS
Fifty-four patients with suspicion of breast cancer were evaluated. Breast images were collected 5-10 minutes after injection of Tc-99m-MDP prior to biopsy. Tissue slides were stained using a rabbit-polyclonal anti-VEGF.


RESULTS
MDP-S showed a diagnostic accuracy of 83.3% in BIRADS category 4 lesions. Four out of 23 benign lesions were false-positive. The tumor to background (TM/BG) ratio of early images of MDP-S was correlated with VEGF staining (p: 0.014) and with tumor size (p: 0.006).


CONCLUSIONS
Early images of Tc-99m-MDP-S may satisfactorily identify cancers with increased neovascularization. MDP-S seems to be an accurate imaging modality, especially in BIRADS category 4 lesions.
Department of Internal Medicine, Division of Oncology, Marmara University Hospital, Turkey. turhal@superonline.com
Nazim S
NS
Turhal
Faysal
F
Dane
Fuat
F
Dede
Mahmut
M
Gumus
P Fulden
PF
Yumuk
Fulya
F
Cakalagaoglu
Dilara
D
Savci
Munire
M
Karaman
Bahadir
B
Gulluoglu
H Turgut
HT
Turoglu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000378:metabolism; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013669:Technetium Tc 99m Medronate / Q000493:pharmacokinetics; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
D019275:Radiopharmaceuticals; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D013669:Technetium Tc 99m Medronate