open access

Vol 7, No 2 (2004)
Published online: 2004-06-02
Submitted: 2012-01-23
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Technetium-99m-MIBI scintimammography by planar and SPECT imaging in the diagnosis of breast carcinoma and axillary lymph node involvement

Miroslav Myslivecek, Pavel Koranda, Milan Kaminek, Vaclav Husak, Marie Hartlova, Milada Duskova, Karel Cwiertka
Nucl. Med. Rev 2004;7(2):151-155.

open access

Vol 7, No 2 (2004)
Published online: 2004-06-02
Submitted: 2012-01-23

Abstract

BACKGROUND: We compared SPECT and planar 99mTc-MIBI scintimammography (SMM) in the detection of primary breast cancer and metastatic axillary lymph node involvement, and the scintigraphic results with the histopathological/cytological findings.
MATERIAL AND METHODS: 303 consecutive patients with 308 suspicious or indeterminate lesions observed in mammographies were entered in this study. After an intravenous injection of 740 MBq of 99mTc-MIBI, anterior supine, right and left lateral planar images in a prone position and a SPECT study were acquired.
RESULTS: 85 malignant and 223 benign breast lesions were confirmed by histopathology/cytology. The overall sensitivity in the detection of breast cancer was 92% (78/85) for SPECT and 82% (70/85) for planar imaging (p = NS), respectively; overall specificity was 91% (204/223) for SPECT and 91% (202/223) for planar scans (p = NS), respectively. Metastatic axillary lymph node involvement was seen in 35 patients; per-axilla overall sensitivity was 66% (23/35) for SPECT and 54% (19/35) for planar images (NS), respectively; overall specificity was 76% (38/50) and 86% (43/50), respectively (NS).
CONCLUSIONS: Our results confirm the high diagnostic accuracy of 99mTc-MIBI scintimammography in the diagnosis of breast cancer, and show SPECT to be slightly more sensitive than planar imaging, especially in detecting malignant breast lesions. We found the sensitivity of both imaging modalities to be quite low in the detection of metastatic axillary lymph node involvement. SPECT provides additional information to planar SMM with respect to the localization of 99mTc-MIBI uptake and tumour extent and improves diagnostic certainty. Our experience suggests that SPECT combined with planar SMM should be used more widely.

Abstract

BACKGROUND: We compared SPECT and planar 99mTc-MIBI scintimammography (SMM) in the detection of primary breast cancer and metastatic axillary lymph node involvement, and the scintigraphic results with the histopathological/cytological findings.
MATERIAL AND METHODS: 303 consecutive patients with 308 suspicious or indeterminate lesions observed in mammographies were entered in this study. After an intravenous injection of 740 MBq of 99mTc-MIBI, anterior supine, right and left lateral planar images in a prone position and a SPECT study were acquired.
RESULTS: 85 malignant and 223 benign breast lesions were confirmed by histopathology/cytology. The overall sensitivity in the detection of breast cancer was 92% (78/85) for SPECT and 82% (70/85) for planar imaging (p = NS), respectively; overall specificity was 91% (204/223) for SPECT and 91% (202/223) for planar scans (p = NS), respectively. Metastatic axillary lymph node involvement was seen in 35 patients; per-axilla overall sensitivity was 66% (23/35) for SPECT and 54% (19/35) for planar images (NS), respectively; overall specificity was 76% (38/50) and 86% (43/50), respectively (NS).
CONCLUSIONS: Our results confirm the high diagnostic accuracy of 99mTc-MIBI scintimammography in the diagnosis of breast cancer, and show SPECT to be slightly more sensitive than planar imaging, especially in detecting malignant breast lesions. We found the sensitivity of both imaging modalities to be quite low in the detection of metastatic axillary lymph node involvement. SPECT provides additional information to planar SMM with respect to the localization of 99mTc-MIBI uptake and tumour extent and improves diagnostic certainty. Our experience suggests that SPECT combined with planar SMM should be used more widely.
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Keywords

99mTc-MIBI; scintimammography; SPECT; breast cancer; axillary lymph node metastasis

About this article
Title

Technetium-99m-MIBI scintimammography by planar and SPECT imaging in the diagnosis of breast carcinoma and axillary lymph node involvement

Journal

Nuclear Medicine Review

Issue

Vol 7, No 2 (2004)

Pages

151-155

Published online

2004-06-02

Bibliographic record

Nucl. Med. Rev 2004;7(2):151-155.

Keywords

99mTc-MIBI
scintimammography
SPECT
breast cancer
axillary lymph node metastasis

Authors

Miroslav Myslivecek
Pavel Koranda
Milan Kaminek
Vaclav Husak
Marie Hartlova
Milada Duskova
Karel Cwiertka

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