Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Clin Nucl Med. 2012 Apr;37(4):344-50. doi: 10.1097/RLU.0b013e31824437b3.
To report our findings from a prospective pilot study evaluating the accuracy of molecular breast imaging (MBI) in assessing tumor response to neoadjuvant therapy (NT) for breast cancer.
Twenty patients with newly diagnosed invasive breast cancer who were scheduled to receive NT underwent MBI before beginning and after completing NT before surgery. MBI was performed using a dual-detector cadmium-zinc-telluride gamma camera system mounted on a modified mammography gantry after patients had received an intravenous injection of 20 mCi of 99mTc sestamibi. Tumor extent was measured on MBI, and tumor-to-background (T/B) ratios of radiotracer uptake were determined through region-of-interest analysis. Pathologic measurement of tumor size was used as a standard and compared with post-NT tumor size derived from MBI.
Three patients in whom post-NT MBI could not be performed because of scheduling problems were excluded from analysis. Eighteen cancers were diagnosed in 17 patients. A correlation coefficient of r = 0.681 (P = 0.002) was found between MBI and residual tumor size. The average T/B ratio on MBI decreased from a pretreatment value of 3.0 to a posttreatment value of 1.4. The relative decrease in T/B ratio did not appear to be predictive of response.
Measurements of tumor size by MBI and T/B ratios are limited in their predictive value regarding the pathologic extent of residual disease in women treated with NT for breast cancer. Alternate tumor-specific radiopharmaceuticals should be evaluated to provide information to improve planning and monitoring of breast cancer treatment.
报告我们在一项前瞻性试点研究中的发现，该研究评估了分子乳腺成像（MBI）在评估乳腺癌新辅助治疗（NT）后肿瘤反应中的准确性。
20 例新诊断为浸润性乳腺癌且计划接受 NT 的患者在开始 NT 前和完成 NT 后在手术前进行了 MBI。MBI 使用安装在改良乳腺摄影龙门架上的双探测器碲锌镉伽马相机系统进行，患者在静脉注射 20mCi 的 99mTc sestamibi 后进行。在 MBI 上测量肿瘤范围，并通过感兴趣区域分析确定放射性示踪剂摄取的肿瘤与背景（T/B）比值。病理测量肿瘤大小作为标准，并与 MBI 得出的 NT 后肿瘤大小进行比较。
由于日程安排问题，无法进行 NT 后 MBI 的 3 例患者被排除在分析之外。17 例患者中有 18 例癌症被诊断。MBI 与残留肿瘤大小之间的相关系数 r = 0.681（P = 0.002）。MBI 上的平均 T/B 比值从预处理值 3.0 降低到治疗后值 1.4。T/B 比值的相对降低似乎不能预测反应。
MBI 测量的肿瘤大小和 T/B 比值在预测接受 NT 治疗的乳腺癌女性残留疾病的病理程度方面具有局限性。应评估替代肿瘤特异性放射性药物，以提供信息，改善乳腺癌治疗的计划和监测。
