Das Birendra Kishore, Biswal Biswa Mohan, Bhavaraju Murali
Department of Nuclear Medicine, Radiotherapy and Oncology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
Malays J Med Sci. 2006 Jan;13(1):52-7.
X-ray mammography has been the backbone of early detection of breast cancer. Several large scale systematic studies have shown that judicious use of X-ray mammography can indeed save life. However, though reasonably sensitive, X-ray mammography lacks in specificity leading to many unnecessary biopsies. Scintimammography is a relatively new imaging method to demonstrate cancer tissue in the breast. A radiopharmaceutical agent (Tc-99m Sestamibi) is administered intravenously and images of the breast are taken under a Gamma Camera. There is no need for any manipulation like compression of the breast as required to be done during mammography. The radiopharmaceutical accumulates in the breast in the presence of cancer tissue which can easily be seen in the images. The affinity of the cancer tissue to this radiopharmaceutical is up to 9 times in comparison to normal breast tissue. Several multi centric studies with blinded image interpretation have established the sensitivity and specificity of scintimammography to be above 85 and 90 % respectively as compared to 89 and 14 % respectively for X-ray mammography. The positive and negative predictive values of scintimamography are 70 and 83 % as against 49 and 57 % respectively for X-ray mammography. With the increasing availability of Nuclear Medicine facilities it is expected that more and more patients will benefi with the use of this new imaging modality .
乳腺X线摄影一直是早期乳腺癌检测的支柱。多项大规模系统研究表明，合理使用乳腺X线摄影确实可以挽救生命。然而，尽管乳腺X线摄影具有一定的敏感性，但缺乏特异性，导致许多不必要的活检。乳腺闪烁显像术是一种相对较新的用于显示乳腺内癌组织的成像方法。静脉注射一种放射性药物（锝-99m 甲氧基异丁基异腈），然后在γ相机下拍摄乳腺图像。与乳腺X线摄影时需要对乳房进行压迫等操作不同，乳腺闪烁显像术无需任何此类操作。放射性药物在癌组织存在的情况下会在乳腺中聚集，这在图像中很容易看到。与正常乳腺组织相比，癌组织对这种放射性药物的亲和力高达9倍。多项采用双盲图像解读的多中心研究表明，乳腺闪烁显像术的敏感性和特异性分别高于85%和90%，而乳腺X线摄影的敏感性和特异性分别为89%和14%。乳腺闪烁显像术的阳性和阴性预测值分别为70%和83%，而乳腺X线摄影的阳性和阴性预测值分别为49%和57%。随着核医学设备的日益普及，预计越来越多的患者将受益于这种新的成像方式。
