99mTc-MIBI Scintimammography Research Articles

99mTc-MIBI scintimammography and digital mammography in the diagnosis of multicentric breast cancer.

To compare diagnostic accuracy of scintimammography (SMG) and digital mammography (DS) in the diagnosis of multicentric breast cancer. Three hundred and sixty seven women with histologically confirmed breast cancer were included in this analysis. All patients were candidates for conservative breast surgery and had cT1-3N0-1 stage of disease. Scintimammography was performed in prone position 5-10min after intravenous injection of 740MBq of technetium-99m-methoxy-isobtyl-isonitrile (99mTc-MIBI) with acquisition time of 10min for every lateral and anterior projection. Digital mammography was done in all women according to a standard clinical protocol. Final diagnosis was established by histopathology. Multicentric breast cancer was defined as 2 or more distinct invasive tumors located in more than one quadrant or additional lesions from the primary tumor of more than 4cm in size. According to histopathological examinations multicentric breast cancer was diagnosed in 47 of 367 (12.8%) patients. Scintimammography was more effective than mammography in detecting multicentric breast cancer: sensitivity: 83.0% vs 40.4% (P<0.001), specificity: 97.8% vs 95.3% (P=0.4), accuracy: 95.9% vs 88.3% (P<0.001), positive and negative predictive values: 84.8% vs 55.9% (P=0.004) and 97.5% vs 91.6% (P<0.001), respectively. Combination of DM and SMG was characterized by increased sensitivity (93.6%), worse specificity (93.4%), accuracy (93.4%) and worse predictive value (67.7%) as compared to only SMG. Scintimammography was significantly much better by all statistical parameters than DM in the detection of multicentric breast cancer. High positive predictive value of scintimammography (84.8%) advocates it as a tool for surgery and radiotherapy planning.

Is Tc-99m sestamibi scintimammography useful in the prediction of neoadjuvant chemotherapy responses in breast cancer? A systematic review and meta-analysis.

To evaluate the accuracy of Tc-99m sestamibi (MIBI) scintimammography in the prediction of neoadjuvant chemotherapy response in breast cancer. 'PubMed' (MEDLINE included) and Embase database were searched for relevant publications in English. Methodological quality of the included studies was assessed with Quality Assessment of Diagnosis Accuracy Studies (QUADAS), and 'Meta-Disc' and 'Stata' software were used to determine pooled sensitivity, specificity, and diagnostic odds ratio (DOR), and construct a summary receiver-operating characteristic curve. Fourteen studies (a total of 503 individuals) fulfilled the inclusion criteria. The pooled sensitivity was 0.86 [95% confidence interval (CI): 0.78-0.92] and the pooled specificity was 0.69 (95% CI: 0.64-0.74). Pooled likelihood ratio (LRp), negative likelihood ratio (LR-), and DOR were 2.64 (95% CI: 1.81-3.85), 0.26 (95% CI: 0.15-0.46), and 12.06 (95% CI: 6.94-20.96), respectively. The area under the summary receiver-operating characteristic curve was 0.86. For the prediction of pathological complete response (10 studies included), the pooled sensitivity and specificity and DOR were 0.86 (95% CI: 0.77-0.93), 0.67 (95% CI: 0.62-0.72), and 11.43 (95% CI: 5.95-21.97). Our results indicated that Tc-99m MIBI scintimammography had acceptable sensitivity in the prediction of neoadjuvant chemotherapy response in breast cancer; however, its relatively low specificity showed that a combination of other imaging modalities would still be needed. Subgroup analysis indicated that performing early mid-treatment Tc-99m MIBI scintimammography (using the reduction rate of one or two cycles or within the first half-courses of chemotherapy compared with the baseline) was better than carrying out later (after three or more courses) or post-treatment scintimammography in the prediction of neoadjuvant chemotherapy response.

Predicative value of 99mTc-MIBI scintimammography in neoadjuvant chemotherapeutic effect of patients with operable breast cancer

To evaluate the relationship between the clearance rate of technetium-99m methoxyisobutylisonitrile ((99m)Tc-MIBI) in scintimammography and the efficacy of neoadjuvant chemotherapy (NCT) of patients with operable breast cancer. Seventy-eight patients with breast cancer underwent (99m)Tc-MIBI scintimammography at pre-NCT. And static planar images were taken at 10 min and 180 min post-scintimammography. The clearance rate was calculated in each patient. And the efficacy of NCT was evaluated after 2 cycles. The clearance rates of patients with a poor or good efficacy of chemotherapy were 24.21% ± 6.38% (n = 14) and 14.13% ± 5.98% (n = 64) respectively. There was significant difference between two groups. And a significant correlation was observed between the efficacy of chemotherapy and the clearance rate of (99m)Tc-MIBI (r = -0.539, P < 0.001). The scintimammography of (99m)Tc-MIBI may be employed to evaluate the efficacy of NCT.

Diagnostic accuracy of Tc-99m-MIBI for breast carcinoma in correlation with mammography and sonography.

To evaluate the accuracy of 99mTc-MIBI scintimammography (SMM) in differentiating malignant breast cancer from benign breast mass and in detecting axillary lymph node metastasis in comparison with mammography and ultrasonography. Comparative cross-sectional study. At the Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN), Karachi, from December 2006 to May 2007. A total of 28 patients (both with breast lumps or/and axillary masses) included were in the study. They underwent clinical examination, mammography and ultrasound imaging followed by planar SMM using a single head detector. All subjects received a 740-1110 MBq bolus injection of 99mTc-Sestamibi. 5-10 minutes and 1 hour delayed images were acquired after the injection. SMM scans were considered positive when there was focal area of increased radiotracer uptake. Qualitative (visual) as well as quantitative evaluation of scans was done and compared with ultrasound and mammography, taking histopathology as Gold standard. Sensitivity, specificity, negative and positive predictive values (NPV and PPV respectively) were determined. There were 22 patients presenting with breast lesions (20 palpable, 2 non-palpable) and 6 patients with axillary lump. Scintimammography accurately predicted malignant lesions in the breast (sensitivity 93.3%, specificity. 71.4%, PPV 87.5%, NPV 83.3%, overall accuracy 86.4%) as well as in patients with axillary metastasis (sensitivity 100%, specificity 66%, PPV 75%, NPV 100%, accuracy 83%). A combination of scintimammography with any other imaging modality provides better results than a single test to detect breast cancer. SMM has good diagnostic accuracy in the detection of breast cancer as well as in axillary metastasis in association with mammography and ultrasound.

Detection and Prediction of Breast Cancer Using Double Phase Tc-99m MIBI Scintimammography in Comparison with MRI

Background: The aim of this study was to investigate the incremental diagnostic value of quantified indices of scintimammography (SMM) additive to magnetic resonance imaging (MRI) for detection of breast cancer. Patients and Methods: Double phase SMM (early: 10 min; delayed: 3 h) was performed in 239 highly suspected breast cancer patients. SMM was analyzed by visual and quantitative methods. Receiver operating characteristic curve (ROC) analyses were performed to determine the optimal visual grade, to calculate cut-off values of quantitative indices, and to evaluate incremental value. Results: Sensitivity and specificity of visual analysis of SMM (V) were 86.4 and 100%, respectively. ROC analysis revealed 96.1% sensitivity and 58.8% specificity of contrastenhanced MRI. The optimal lesion to non-lesion (L/N) ratios were 1.84 for early and 1.04 for delayed. When early L/N 1.84 was used as cut-off, sensitivity and specificity of SMM were 67.8 and 97.1%, respectively. When delayed L/N 1.04 was used, sensitivity and specificity were 88.3 and 55.9%, respectively. Among the various variables of double phase SMM and MRI, early L/N was the potent predictor for breast cancer. Conclusion: MRI and visual analysis early L/N showed similar diagnostic accuracy for breast cancer in the current study. Early L/N is a potential predictor for breast cancer. Further studies are needed to confirm these results and improve statistical accuracy.

Dual phase qualitative and quantitative 99mTc-MIBI scintimammography for predicting response to neoadjuvant chemotherapy in breast cancer.

To determine the role of dual phase 99mTc-MIBI scintimammography in predicting chemotherapeutic response in breast cancer. Cross-sectional study. Karachi Institute of Radiology and Nuclear Medicine (KIRAN), from September 2004 to March 2005. Female patients with locally advanced breast cancer being planned for the anthracycline-based neoadjuvant chemotherapy were included in this study. All subjects received a 740 MBq bolus intravenous injection of 99mTc-MIBI. Ten minutes and 3 hours post-injection planar images were obtained in prone, lateral and supine positions using double head gamma camera. MIBI washout was scored as follows: >30% as a positive prognostic test (predicting a poor response to chemotherapy) and <30% as negative prognostic test (predicting a good response to chemotherapy). Qualitative analysis of MIBI scans was also performed and categorized as visual wash-out or no visual washout as apparent on the early and delayed images. The criterion for the good and bad response was the reduction of >50% and <50% in the tumour burden respectively. Accuracy analysis, Chi-square test and Wilcoxan sign rank test were applied. There were 32 females (mean age: 46.3 years; median age 46 years; age range 33-65 years). Quantitative dual phase 99mTc-MIBI scintimammography was found to be a good predictor of chemotherapeutic response in breast cancer. These were true positive in 8 patients and true negative in 19 patients with sensitivity (Sens.) 72%, specificity (Spec.) 90%, Positive Predictive Value (PPV) 80%, Negative Predictive Value (NPV) 86.5%, p <0.03. Receiver Operating Characteristics (ROC) curve analysis demonstrates 30% as a cut-off value for the wash-out in quantitative dual phase MIBI for the prediction of the chemotherapeutic response. In comparison, qualitative scintimammography had Sens. 82%, Spec. 53%, PPV 29%, NPV 93% and p <0.38. Statistical difference was found between early and delayed uptake ratios in the responders and non-responders. Quantitative dual phase 99mTc-MIBI scintimammography is a simple, reliable, non-invasive and effective tool for predicting the response to neoadjuvant chemotherapy. Furthermore, quantitative assessment is more precise than qualitative (visual wash-out) approach.

Chest wall recurrence of breast cancer demonstrated on 99mTc-MIBI scintimammography

The mastectomy site is usually assessed by clinical examination and ultrasonography for recurrence of breast cancer, although post-surgical and radiotherapy changes limit the accuracy of these methods. MRI has been used successfully but it remains an expensive modality and may not be readily available. Scintimammography is an alternative method which has the advantage of not being affected by post-operative morphological changes. To evaluate the usefulness of planar Tc-MIBI scintimammography and supine Tc-MIBI SPECT in the detection of chest wall recurrence post-mastectomy. The study population comprised of 26 patients (mean age, 47.15 years; median age 47 years; age range, 22-77 years) with suspected chest wall recurrence of breast cancer on clinical examination. All patients received a 740-1000 MBq bolus i.v. injection of Tc-MIBI preferably in the pedal vein. At 5-10 min post-injection planar images were obtained in the prone lateral and supine anterior positions using a double-head gamma camera. After planar imaging supine SPECT was performed (64 projections, 64x64 matrix, 30 s.frame). MIBI uptake was scored as follows: 1 = normal uptake (compared with contralateral side); 2 = focal low uptake (equivocal); and 3 = focal high uptake (positive). All patients underwent excision biopsy or FNAC for tissue diagnosis. FNAC was considered sufficient if unequivocally positive. For the 26 patients, planar scintimammography was found true positive in 14 and true negative in seven. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 78%, 87.5%, 93%, 64% and 81%, respectively (P<0.001). SPECT showed a significantly higher overall sensitivity than planar imaging (89% vs. 78%; P<0.001). SPECT and planar imaging showed the same specificity (87.5%). SPECT showed a significantly higher negative predictive value and accuracy than planar imaging (78% vs. 64% and 88% vs. 81%, respectively; P<0.05). Scintimammography is a reliable diagnostic tool and appears accurate in the detection of chest wall recurrence. SPECT shows high positive predictive value and aids in the diagnosis of the chest wall recurrence with greater confidence.

Incidental Detection of Rounded Atelectasis During Tc-99m MIBI Scintimammography

Focal pulmonary uptake resembling a malignant tumor was incidentally detected in a 37-year-old woman with recurrent breast cancer during Tc-99m MIBI scintimammography. The lesion had the characteristic computed tomography (CT) features of rounded atelectasis with a relatively low uptake on FDG-PET. The lesion was unchanged on follow-up CT and scintimammography performed 1 year later.

Comparison of early and delayed quantified indices of double‐phase 99mtc mibi scintimammography in the detection of primary breast cancer

To compare the diagnostic accuracy and incremental diagnostic role of quantitative indices of early and delayed lesion to non-lesion ratios (L/Ns) in the detection of primary breast cancer. Double-phase (99m)Tc MIBI scintimammography (SMM) (early 10 min, delayed 3 h) was performed after injection of 750 MBq of (99m)Tc MIBI in 446 highly suspected breast cancer patients (malignant: 311, benign: 135). For visual analysis, five scoring methods were used, and, for quantitative analysis, early and delayed L/Ns were calculated. Receiver operating characteristic curve (ROC) analyses were performed to determine the optimal visual grade, and to calculate cut-off values of quantitative indices for differentiation of malignant and benign diseases and to investigate whether the quantitative indices could provide incremental diagnostic values in addition to visual analysis. Optimal visual grades were above 4 and 5 in the detection of breast cancer. Sensitivity was 84.2% and specificity 79.3%; the area under the curve (AUC) was 0.832 (95% CI, 0.794-0.866) and standard error was 0.019. Early and delayed L/Ns of malignant breast disease were significantly higher than those of benign disease (early: 2.01 +/- 0.99 versus 1.13 +/- 0.26 (P < 0.001); delayed: 1.68 +/- 0.69 versus 1.11 +/- 0.23 (P < 0.001)). The optimal L/Ns for the detection of primary breast cancer were 1.27 for early and 1.12 for delayed imaging. When early L/N 1.27 was used as cut-off value for the detection of primary breast cancer, the sensitivity of SMM was 77.8% and specificity 85.2%. The AUC was 0.856 (95% CI, 0.820-0.888). When delayed L/N 1.12 was used, sensitivity and specificity were 81.4% and 78.5%, respectively. The AUC was 0.834 (95% CI, 0.796-0.867). The ROC comparison of early and delayed L/N showed no statistical difference in the detection of malignant breast disease (P=0.403). When the delayed L/N was added to the early one, early plus delayed quantitative analysis (E+D) showed 86.5% sensitivity and 74.8% specificity. However, the AUCs of E+D (0.854, 95% CI, 0.767-0.842) and early L/N (E) (0.856) showed no statistical difference (P=0.614). When grades 4 and 5 were used as cut-off visual grade, sensitivity and specificity were 84.2% and 79.3%, respectively. When the E was added to visual grade, visual plus early L/N (V+E) showed 89.4% sensitivity and 77% specificity. The AUC of V+E (0.867, 95% CI, 0.832 0.897) was significantly higher than that of visual analysis (V) (0.832, 95% CI, 0.794-0.866, P < 0.001). When the delayed L/N (D) was added to visual grade, visual plus delayed L/N (V+D) showed 89.4% sensitivity and 74.1% specificity. The AUCs of V+D (0.852, 95% CI, 0.816-0.884) and V revealed no statistical differences (P = 0.052). From this study, the optimal visual grades for diagnosis of breast cancer were grades 4 and 5; the cut-off values of L/Ns were 1.27 for early and 1.12 for delayed imaging. It was also found that early L/Ns provide incremental value in addition to visual analysis. However, delayed L/N revealed no incremental value. Therefore, the delayed image should not be routinely performed for purposes of primary breast cancer detection

Scintimammographic Findings of Phyllodes Tumor of the Breast in a Double-phase Study with Tc-99m (V)DMSA and Tc-99m MIBI: a Case Report

We present a case of phyllodes tumor of the breast in a 78-year-old woman evaluated with Tc-99m (V)DMSA and Tc-99m MIBI scintimammography, acquired in separate sessions (10 and 60 min post-injection). Tc-99m (V)DMSA was accumulated intensely within the mass [tumor to background ratio (T/B) >3], whereas Tc-99m MIBI had significantly lower uptake (T/B 1.9). Histology revealed a phyllodes tumor (maximum diameter 15 cm) and approximately three mitoses over 10 fields of view (FOV) x40, foci of epithelial hyperplasia and apocrine metaplasia. Stromal Ki-67 expression was 7%. The tumor was considered to be benign and the patient underwent mastectomy. One year later the patient presented with local malignant recurrence of the disease with over 15 mitoses per 10 FOV. Tc-99m (V)DMSA seems to have an advantage over Tc-99m MIBI in detecting mesenchymal tumors with unforeseen biological behavior and Ki-67 over-expression, such as phyllodes tumors, even with primary negative histological findings.

Clinical experience with 99mTc-MIBI scintimammography in patients with breast microcalcifications

The aim of this study was to evaluate whether 99mTc-MIBI scintimammography can improve the diagnostic value of mammography for the differentiation of benign and malignant breast microcalcifications. In 41 women presenting 45 clusters of microcalcifications, a 99mTc-MIBI scintimammography was performed before open biopsy. There were 24 malignant lesions (53%). The sensitivity (SE) and specificity (SP) of 99mTc-MIBI scintimammography were 58.3% and 81%, and the positive and negative predictive values (PPV, NPV) were 78% and 63%, respectively. SE and PPV increased for lesions over 10 mm and for the younger patients (under 50 years). No correlation was found between true positive uptake and breast cancer invasiveness: 69% (9/13) for invasive lesions and 45% (5/11) for noninvasive lesions ( p=0.48). 99mTc-MIBI scintimammography was more often positive in high grade than in low- or intermediate-grade ductal carcinoma in situ ( p=0.03). The results were analysed according to the morphologic aspect of the microcalcifications. 99mTc-MIBI scintimammography could not be used for routine evaluation of all the microcalcifications detected by mammography.

MRI, scintimammography and histology in the assessment of multi-focal breast cancer

Background and aim: MRI and scintimammography of the breast play a valuable role in patients with equivocal findings in breast imaging. The aim of this study was to evaluate the efficacy of preoperative scintimammography and MRI in the detection of multi-focal breast cancer and compare these results with histology. Methods: Twenty-nine patients underwent contrast enhanced MRI and scintimammography. MRI was performed on 1.3 or 1.5 T magnet, with rapid imaging performed after bolus injection of Gd-DTPA. Radionuclide imaging was performed 5–10 min after an intravenous injection of 740 MBq 99mTc-MIBI. The results were compared with histopathology. The histology examination was performed on the mastectomy specimens (10 mm slices) with 1 mm slices at any site of abnormality. Results: Invasive cancer was confirmed in 29 patients. MRI identified 8 as unifocal, 12 as multifocal, 4 as post-surgical changes/recurrence, 1 intraductal. 99mTc-MIBI identified 13 as unifocal, 12 as multifocal and 2 as normal. On pathological examination only 7 were confirmed as multifocal. Conclusion: MRI and 99mTc-MIBI scintimammography both over-identify multifocal disease and therefore care must be taken in using these techniques to plan surgery.

Comparison of quantitative and visual analysis of Tc-99m MIBI scintimammography for detection of primary breast cancer

Tc-99m MIBI scintimammography (SMM) is known to be a useful diagnostic tool for primary breast cancer. We conducted this study to compare the quantitative and visual analysis for detection of primary breast cancer and also investigated the incremental role of quantitative index of SMM. Methods: 520 highly suspected breast cancer patients (malignant 370: palpable 232, nonpalpable 138; benign 150: palpable 67, nonpalpable 83) were included in this study. The SMM was performed 10 min after the injection of 750 MBq of Tc-99m MIBI. For visual analysis, three-scoring based method was used. The lesions to non-lesion ratios (L/Ns) were calculated. Receiver operating characteristic curve (ROC) analyses were performed to determine the optimal visual grade, to calculate cut-off value of L/N and to investigate whether the L/N could provide incremental value additive to visual analysis. The patients were divided into four groups according to the tumor size (group A: size ≤ 1 cm; group B: 1 cm < size ≤ 3 cm; group C: 3 cm < size ≤ 5 cm; group D: size > 5 cm). Also, the patients were divided into two groups according to age (under and over 45 years) to investigate incremental value of quantitative analysis. Results: When visual grade 3 was used as the cut-off grade, the sensitivity and specificity were 82.7 and 78%, respectively. The L/N of malignant breast disease was significantly higher than that of benign (2.00±1.88 versus 0.60±0.7, P<0.01). When L/N of 1.27 was used as the cut-off value, the sensitivity and specificity of SMM were 77.6 and 83.3%, respectively. When the L/N was added to visual grade, the area under curve (AUC) of visual + quantitative (V+Q) analyses was higher than that of visual (V) and quantitative (Q) analyses (AUC 0.874 versus 0.803, P<0.01). In group A and B, the AUCs of V+Q (0.861, 0.895) were higher than those of V (0.808, 0.781) and Q (0.808, 0.813). In group C, the AUC of V+Q (0.847) was higher than that of Q (0.803, P=0.041). However, the AUC of V (0.915) was higher than that of V+Q ( P=0.009). In group D, there were no statistical differences between V+Q (0.685) and V (0.570, P=0.058) and Q (0.620, P=0.145). The V+Q revealed incremental value in the detection of primary breast cancer in both age groups. Also, in older age patients group (over 45 years), the specificities of Q and V+Q were higher than younger group (under 45 years). For axillary lymph node involvement, the sensitivity, specificity, and accuracy of SMM were 66.9, 70.1, and 68%, respectively. Conclusion: From this study, the optimal visual grade for diagnosis of breast cancer was grade 3 and cut-off value of L/N was 1.27. Also, we found that the L/N provides incremental value additive to visual analysis. Especially, when the tumor is small (size ≤3 cm), the L/N should be obtained for the diagnosis of breast cancer. The V+Q revealed incremental value in the detection of primary breast cancer in both age groups. Also, in older age patients group, the specificities of Q and V+Q were higher than younger group.

Breast sonography in malignant masses correlation with 99m Tc-MIBI scintimammography based on the mitotic activities

Breast sonography in malignant masses correlation with 99m Tc-MIBI scintimammography based on the mitotic activities

Calcitonin gene related peptide (CGRP) and calcitonin (CT) immunohistochemistry in relation with the presence of microcalcifications (MC) in invasive and preinvasive breast lesions: Influence in Tc-99m (V)DMSA and Tc-99m MIBI scintimammography (SM)

Calcitonin gene related peptide (CGRP) and calcitonin (CT) immunohistochemistry in relation with the presence of microcalcifications (MC) in invasive and preinvasive breast lesions: Influence in Tc-99m (V)DMSA and Tc-99m MIBI scintimammography (SM)

Comparison of diagnostic roles of ultrasound, Tc-99m MIBI scintimammography and contrast enhanced MRI in detection of breast cancer

Comparison of diagnostic roles of ultrasound, Tc-99m MIBI scintimammography and contrast enhanced MRI in detection of breast cancer

Value of 99mTc-MIBI scintimammography in women with impalpable breast lesions seen on mammography.

To find out if 99mTc-methoxyisobutylisonitrile scintimammography (MIBI) is useful in the evaluation of impalpable breast lesions in women referred for biopsy after mammography screening. Observational and prospective study. Radiological screening campaign in Spain. 36 patients referred between September 1997 and June 1998 (37 biopsies) with impalpable breast lesions referred consecutively from a screening campaign. Ages ranged from 50 to 64 years. Mammography, ultrasound, MIBI, and wire-guided biopsy. Mean values for sensitivity, specificity, positive predictive value, and negative predictive value for scintimammography were 78.9, 72.2, 75, and 76.5 respectively (p = 0.002). The logistic regression analysis showed that 99mTc-MIBI scintimammography result predicted (p = 0.003) the risk of breast cancer in this group of patients (odds ratio: 9.75), particularly infiltrating ductal carcinoma. MIBI scintimammography in patients referred for biopsy after mammography screening does not so much rule out cancer as confirm the diagnosis. Its practical benefit would be not so much avoiding biopsy for these patients as aiding in planning the radicality of their excision.

99mTc-MIBI scintimammography as a complement of the mammography in patients with suspected breast cancer. A multicentre experience

The aim of this work has been to evaluate the clinical usefulness of99mTc-MIBI scintimammography, used as a complement to mammography, in the study of patients with suspected breast cancer. We performed prone breast scintigraphy in 253 patients (268 lesions) with suspected breast cancer. The size and degree of the suspected breast cancer was evaluated by mammography. Diagnosis was established by biopsy. Malignancy was diagnosed in 155 lesions and benign diseases in 113. The results of the scintimammography were a sensitivity of 91%, a specificity of 71%, PPV=81% and NPV=85%. In lesions smaller than 1 cm, sensitivity and specificity were 57% and 100%; in lesions with a diameter of between 1 and 2 cm, these figures were 90% and 72% respectively, and in lesions of more than 2 cm the sensitivity was 99% and the specificity 50%. On mammography, 155 lesions were considered as having a high suspicion of malignancy, whilst 72 were indeterminate and 41 had a low probability. In lesions with a low or indeterminate suspicion of malignancy on mammography, the sensitivity and NPV of the scintimammography were 97% and 98%. Scintimammography is a useful technique in the study of lesions where breast cancer is suspected. Scintimammography results are closely related to tumour size and the degree of mammographic suspicion. Scintimammography can be useful where mammography identifies lesions with a low or indeterminate suspicion of malignancy.

15. The added value of 99Tcm-MIBI scintimammography in diagnosing breast cancer is not age dependent

15. The added value of 99Tcm-MIBI scintimammography in diagnosing breast cancer is not age dependent

Diagnostic value of 99mTc MIBI scintimammography in patients with breast lesions

This study has aimed to determine the diagnostic value of the scintimammography with 99mTc-MIBI in the detection of primary breast cancer and to verify its clinical usefulness. Sixty-three female patients (age range 27-83) with breast lesions detected by physical examination, ultrasonography, and/or mammography were prospectively included in this study. An anterior and prone lateral planar 99mTc-MIBI scintimammography was performed on all patients. The final diagnosis was achieved by histopathological examination in 49 patients and clinical followup (at least one year) in 14 patients. Histopathological diagnosis confirmed that 15 lesions were malignant and 34 lesions were benign. All the malignant lesions were larger than 1 cm. The 99mTc-MIBI scintimammography showed increased focal uptake in 17 lesions (two of them were benign and the other 15 were malignant). The diffuse heterogeneous uptake pattern was considered as benign. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy values for breast carcinoma were calculated as 100%, 96%, 88%, 100%, 97%, respectively. We concluded that 99mTc-MIBI scintimammography could be a valuable method in the differentiation of malignant breast neoplasm larger than 1 cm size from benign ones, especially when the uptake pattern was considered.