Soluri A, Scopinaro F, De Vincentis G, Varvarigou A, Scafé R, Massa R, Schillaci O, Spanu A, David V
Institute of Biomedical Technologies, CNR, Rome, Italy.
Anticancer Res. 2003 May-Jun;23(3A):2139-42.
A pilot study has been carried out in order to verify the feasibility of scintigraphic driving for breast biopsy. A new high resolution (HR) gamma ray detector, the imaging probe (IP), and 99mTc [13Leu] Bombesin (99mTc BN), have been used to drive a mammotome biopsy needle after having fused radioisotope with digital X-ray images. IP is a mobile, high resolution, miniaturised gamma camera, whose field of view is one inch and whose spatial resolution is 2 mm. 99mTc BN is a new radiotracer derived from the well-known peptide, that has already shown very high sensitivity in detecting breast cancer.
Five patients very suspicious for breast cancer were studied. 185 MBq of 99mTc BN were i.v. injected and dynamic prone scintimammography was performed for 20 minutes with a conventional large field of view gamma camera. IP was matched with the biopsy system and digital X-ray device of a mammotome system, in order to fuse images and to use the mammotome pointer indifferently on X-ray, scintigraphic and fused images. Biopsy samples were counted and weighed: uptake was expressed as counts sec-1 gr-1. Samples were classified into high, intermediate and low uptake. Conventional histological assessment was blindly performed on the samples.
All of the patients showed cancer. The T categorisation was T1a for two cancers and T1b for 3. Dynamic prone scintimammography with conventional gamma camera, as well as HR scintigraphy with IP showed spots of 99mTc BN uptake. Maximal mismatch between X-ray lesions and of hot spots imaged with IP before mammotome scintigraphy was 3.4 mm. All the high uptake samples and all but two of the intermediate uptake samples showed cancer, whereas histology found malignant tissue in only 2 out of the 8 low uptake samples.
99mTc BN confirms its high sensitivity in detecting breast cancer. IP is able to drive or co-drive breast biopsy when used with appropriate radiopharmaceuticals.
为验证乳腺活检闪烁成像引导的可行性，开展了一项初步研究。一种新型高分辨率（HR）伽马射线探测器——成像探头（IP），以及99mTc [13亮氨酸] 蛙皮素（99mTc BN），在将放射性同位素与数字X线图像融合后，用于引导乳腺旋切活检针。IP是一种可移动的高分辨率小型伽马相机，其视野为1英寸，空间分辨率为2毫米。99mTc BN是一种源自著名肽的新型放射性示踪剂，在检测乳腺癌方面已显示出非常高的灵敏度。
对5例高度怀疑患有乳腺癌的患者进行了研究。静脉注射185 MBq的99mTc BN，并用传统大视野伽马相机进行20分钟的动态俯卧位乳腺闪烁成像。将IP与乳腺旋切系统的活检系统和数字X线设备相匹配，以便融合图像，并可在X线、闪烁成像及融合图像上随意使用乳腺旋切指针。对活检样本进行计数和称重：摄取量以每秒计数每克表示。样本分为高摄取、中摄取和低摄取。对样本进行盲法常规组织学评估。
所有患者均患有癌症。其中2例癌症的T分类为T1a，3例为T1b。使用传统伽马相机进行的动态俯卧位乳腺闪烁成像以及使用IP进行的HR闪烁成像均显示有99mTc BN摄取点。在乳腺旋切闪烁成像前，X线病变与IP成像的热点之间的最大不匹配为3.4毫米。所有高摄取样本以及除2个外的所有中摄取样本均显示患有癌症，而组织学检查发现8个低摄取样本中只有2个含有恶性组织。
99mTc BN在检测乳腺癌方面证实了其高灵敏度。IP与适当的放射性药物一起使用时，能够引导或辅助引导乳腺活检。
