title: 99mTc-3P4-RGD2 scintimammography in the assessment of breast lesions: comparative study with 99mTc-MIBI.
abstract: OBJECTIVE
  To compare the potential application of (99m)Tc-3P-Arg-Gly-Asp ((99m)Tc-3P4-RGD2) scintimammography (SMM) and (99m)Tc-methoxyisobutylisonitrile ((99m)Tc-MIBI) SMM for the differentiation of malignant from benign breast lesions.
  
  
  METHODS
  Thirty-six patients with breast masses on physical examination and/or suspicious mammography results that required fine needle aspiration cytology biopsy (FNAB) were included in the study. (99m)Tc-3P4-RGD2 and (99m)Tc-MIBI SMM were performed with single photon emission computed tomography (SPECT) at 60 min and 20 min respectively after intravenous injection of 738 ± 86 MBq radiotracers on a separate day. Images were evaluated by the tumor to non-tumor localization ratios (T/NT). Receiver operating characteristic (ROC) curve analysis was performed on each radiotracer to calculate the cut-off values of quantitative indices and to compare the diagnostic performance for the ability to differentiate malignant from benign diseases.
  
  
  RESULTS
  The mean T/NT ratio of (99m)Tc-3P4-RGD2 in malignant lesions was significantly higher than that in benign lesions (3.54 ± 1.51 vs. 1.83 ± 0.98, p<0.001). The sensitivity, specificity, and accuracy of (99m)Tc-3P4-RGD2 SMM were 89.3%, 90.9% and 89.7%, respectively, with a T/NT cut-off value of 2.40. The mean T/NT ratio of (99m)Tc-MIBI in malignant lesions was also significantly higher than that in benign lesions (2.86 ± 0.99 vs. 1.51 ± 0.61, p<0.001). The sensitivity, specificity and accuracy of (99m)Tc-MIBI SMM were 87.5%, 72.7% and 82.1%, respectively, with a T/NT cut-off value of 1.45. According to the ROC analysis, the area under the curve for (99m)Tc-3P4-RGD2 SMM (area = 0.851) was higher than that for (99m)Tc-MIBI SMM (area = 0.781), but the statistical difference was not significant.
  
  
  CONCLUSIONS
  (99m)Tc-3P4-RGD2 SMM does not provide any significant advantage over the established (99m)Tc-MIBI SMM for the detection of primary breast cancer. The T/NT ratio of (99m)Tc-3P4-RGD2 SMM was significantly higher than that of (99m)Tc-MIBI SMM. Both tracers could offer an alternative method for elucidating non-diagnostic mammograms.
authors.affiliation: China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Qingjie
authors.initials: Q
authors.lastname: Ma
authors.affiliation: China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.affiliation: China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Gao
authors.affiliation: China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Tiefeng
authors.initials: T
authors.lastname: Ji
authors.affiliation: China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wen
authors.affiliation: China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Song
authors.affiliation: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhu
authors.affiliation: China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Zheli
authors.initials: Z
authors.lastname: Xu
authors.affiliation: China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Liu
mesh_terms: D000328:Adult; D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000008:administration & dosage* / Q000493:pharmacokinetics; D010456:Peptides, Cyclic / Q000008:administration & dosage* / Q000493:pharmacokinetics; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000008:administration & dosage* / Q000493:pharmacokinetics; D017256:Technetium Tc 99m Sestamibi / Q000008:administration & dosage* / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D055815:Young Adult
chemical_list: D015609:Organotechnetium Compounds; D010456:Peptides, Cyclic; D019275:Radiopharmaceuticals; C561921:technetium 99m (HYNIC-3PRGD(2))(tricine)(TPPTS); D017256:Technetium Tc 99m Sestamibi