Coover Leonard R, Caravaglia Gina, Kuhn Phyllis
Department of Nuclear Medicine, Hamot Medical Center, Erie, Pennsylvania, USA.
J Nucl Med. 2004 Apr;45(4):553-8.
This study assessed the utility of scintimammography using a standard gamma-camera and a dedicated breast camera as an adjuvant to mammography and clinical examination.
The study population comprised 37 patients with dense breasts and a family or personal history of breast cancer. The subjects had no suggestive clinical or mammographic findings. After intravenous administration of (99m)Tc-sestamibi, the patients were imaged using a conventional gamma-camera and a dedicated breast camera that allowed breast compression during image acquisition. Images were interpreted independently by 2 reviewers. All patients with positive scintimammography findings underwent biopsy.
Dedicated breast camera results were positive in 13.5% (5/37) of patients. Biopsy of these 5 patients yielded 3 carcinomas: an infiltrating lobular carcinoma, a ductal carcinoma in situ, and an infiltrating tubular carcinoma. These 3 carcinomas were undetectable by clinical breast examination or mammography, even on retrospective review. Only one of these, the tubular carcinoma, was readily detectable by the standard gamma-camera.
Scintimammography using a dedicated breast camera may augment mammography and clinical breast examination for the subset of women who have dense breast tissue and are at high risk of breast cancer.
本研究评估了使用标准伽马相机和专用乳腺相机进行乳腺闪烁显像作为乳房X线摄影和临床检查辅助手段的效用。
研究人群包括37例乳腺致密且有乳腺癌家族史或个人史的患者。这些受试者没有提示性的临床或乳房X线摄影检查结果。静脉注射(99m)锝-甲氧基异丁基异腈后,使用传统伽马相机和在图像采集过程中允许乳腺压迫的专用乳腺相机对患者进行成像。图像由2名阅片者独立解读。所有乳腺闪烁显像结果阳性的患者均接受活检。
专用乳腺相机检查结果在13.5%(5/37)的患者中呈阳性。这5例患者的活检发现3例癌:1例浸润性小叶癌、1例原位导管癌和1例浸润性小管癌。即使进行回顾性复查,这3例癌通过临床乳腺检查或乳房X线摄影也无法检测到。其中只有小管癌可通过标准伽马相机轻易检测到。
对于乳腺组织致密且乳腺癌高危的女性亚组,使用专用乳腺相机进行乳腺闪烁显像可能会增强乳房X线摄影和临床乳腺检查。