Phys Med. 2006;21 Suppl 1:11. doi: 10.1016/S1120-1797(06)80015-3.
Early detection of breast cancer is a prerequisite for treatment success and improvement of survival. In tumors under 10mm diameter the standard morphological methods of imaging such as sonography, mammography and MRI imaging are of lesser specificity and loose sensitivity. Under 5mm detection of breast cancer remains a chalenge. Since recent years scinti-mammography using perfusion weighted enrichment of 99m-Tc-MIBI for imaging has become a standard technique indetection of breast cancer. It is superior when ever small lesions with increased perfusion are to be expected. it is used specially in dense breast patients. Other functional methods such as F-18-FDG-PET, C-11-Methionine-PET and the use of Ga-68-Somatostatin- or Ga-68-Bombesin-PET have been discussed for the early detection and therapy control of breast cancer patents. Especially the high specific low background receptor-PET imaging exels over the standard methods because of its ability to detect lesions even below 2 mm, as it has been shown for the Ga-68-DOTA-somatostatins. Because simple exchange of the diagnostic PET isotope against a therapeutical isotope like Lu-177, Y-90, Ga-67 or Cu-67 the receptor PET is directly linked to radio-peptide therapy. As the studies of J. C. Reubi et alii have been shown several peptide receptors are expressed in breast cancer, like the sms receptors and the gastrin releasing peptide receptors (bombesin receptors). One of the most widely expressed receptors expressed in breast cancer, which tends to be relatively selective, is NPY1 receptor. Intensive work had been done on the development of peptide ligands by A. Beck-Sicklinger and her group. These new developed peptides are very promising in combination with somatostatin and bombesin derivatives. Dedicated breast pet devices in combination with these high specific tracers have great potential to open and entire new quality in early detection of breast cancer and may lead to its radiopeptide therapy.
早期发现乳腺癌是治疗成功和提高生存率的前提。在直径小于 10 毫米的肿瘤中，超声、乳房 X 线照相术和 MRI 成像等标准形态学方法的特异性和敏感性较低。在直径小于 5 毫米的情况下，乳腺癌的检测仍然是一个挑战。近年来，使用 99mTc-MIBI 灌注加权放射性核素闪烁显像进行闪烁乳腺成像已成为乳腺癌检测的标准技术。在预计有小而灌注增加的病变时，它具有优越性。它特别适用于致密乳腺患者。其他功能方法，如 F-18-FDG-PET、C-11-蛋氨酸-PET 以及使用 Ga-68-生长抑素或 Ga-68-蛙皮素-PET 已被讨论用于早期发现和治疗控制乳腺癌患者。特别是高特异性低背景受体-PET 成像优于标准方法，因为它能够检测到甚至小于 2 毫米的病变，如 Ga-68-DOTA-生长抑素所示。由于可以用治疗性同位素如 Lu-177、Y-90、Ga-67 或 Cu-67 简单地替代诊断性 PET 同位素，受体 PET 直接与放射性肽治疗相关。正如 J.C. Reubi 等人的研究表明，在乳腺癌中表达了几种肽受体，如 SMS 受体和胃泌素释放肽受体（蛙皮素受体）。在乳腺癌中表达最广泛的受体之一是 NPY1 受体，它倾向于相对选择性。A. Beck-Sicklinger 及其团队在肽配体的开发方面做了大量工作。这些新开发的肽与生长抑素和蛙皮素衍生物结合非常有前途。专门的乳腺 PET 设备与这些高特异性示踪剂结合具有很大的潜力，可以在早期发现乳腺癌方面开辟全新的质量，并可能导致其放射性肽治疗。
