Listewnik Maria H, Birkenfeld Bozena, Foszczyńska-Kłoda Małgorzata, Listewnik Mariusz J, Piwowarska-Bilska Hanna, Zorga Piotr
Zakład Medycyny Nuklearnej Pomorskiego Uniwersytetu Medycznego w Szczecinie, ul. Unii Lubelskiej 1, 71-252 Szczecin.
Ann Acad Med Stetin. 2011;57(1):73-8.
The aim of this study was to assess the efficacy of Tc-99m sestamibi scintimammography in the prediction and evaluation of tumour response to neoadjuvant chemotherapy in patients with locally advanced breast cancer.
The subjects consisted of 14 female patients with unilateral locally advanced breast cancer eligible for anthracycline-based neoadjuvant chemotherapy followed by surgery. The patients underwent mastectomies with pathologic evaluation of the residual tumour size. The early and delayed static imaging were undertaken in all subjects at 10 and 120 minutes after intravenous injection with 720-1080 MBq of Tc-99m MIBI. Patients lay prone on the scintimammographic pad (provided by the IAEA). The acquisition included three positions: both lateral prone and anterior supine. Early, delayed tumour to background ratios (TBR) and washout rate (WOR) were calculated. Three sets of scintimammography images were obtained: baseline study (BL), the first follow-up study (FF) after two cycles of chemotherapy and the second follow-up (SF) scan on completion of chemotherapy and prior to surgery. Clinical response was evaluated following WHO criteria and classified as complete response (CR), partial response (PR), stable disease (StD) and progressive disease (PD). All patients underwent BS, seven of them FF and eight completed the study with SF.
The only statistically significant differences in Student's t-test for matched pairs were found between mean values of TBR10 and TBR120 in BL and FF study however in the SF study it was not significant. Other differences between the mean values of TBR10, TBR120 and WOR in BL/FF, BL/SF and FF/SF studies were not statistically significant.
The results obtained are encouraging, but further investigations are needed.
本研究旨在评估锝-99m甲氧基异丁基异腈乳腺闪烁显像在预测和评估局部晚期乳腺癌患者新辅助化疗的肿瘤反应中的疗效。
研究对象为14例符合基于蒽环类药物新辅助化疗后手术的单侧局部晚期乳腺癌女性患者。患者接受乳房切除术，并对残余肿瘤大小进行病理评估。所有受试者在静脉注射720-1080MBq锝-99m甲氧基异丁基异腈后10分钟和120分钟进行早期和延迟静态显像。患者俯卧在乳腺闪烁显像垫（由国际原子能机构提供）上。采集包括三个体位：双侧俯卧位和前位仰卧位。计算早期、延迟肿瘤与背景比值（TBR）和洗脱率（WOR）。获得三组乳腺闪烁显像图像：基线研究（BL）、化疗两个周期后的首次随访研究（FF）以及化疗完成后手术前的第二次随访（SF）扫描。根据世界卫生组织标准评估临床反应，并分为完全缓解（CR）、部分缓解（PR）、疾病稳定（StD）和疾病进展（PD）。所有患者均接受了基线扫描，其中7例接受了首次随访扫描，8例完成了第二次随访扫描。
配对样本t检验中，仅在基线研究和首次随访研究中TBR10和TBR120的平均值之间发现了统计学上的显著差异，然而在第二次随访研究中差异不显著。基线研究/首次随访研究、基线研究/第二次随访研究和首次随访研究/第二次随访研究中TBR10、TBR120和WOR平均值之间的其他差异无统计学意义。
所获得的结果令人鼓舞，但仍需要进一步研究。
