Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Clinics (Sao Paulo). 2013;68(3):283-9. doi: 10.6061/clinics/2013(03)oa01.
Mammography has been established as the gold standard for the detection of breast cancer, and imaging techniques such as ultrasonography, magnetic resonance imaging, scintigraphy and positron emission tomography may be useful to improve its sensitivity and specificity. The objective of this study with breast scintigraphy was to evaluate the uptake of 99mTc-thymine in mammary lesions.
A total of 45 patients were included in this study. Thirty-three patients (73%) were subjected to surgery or percutaneous biopsy, providing histopathological data. The other 12 patients who remained under surveillance received clinical examinations and biannual mammography with a normal follow-up of at least three years, the data from which were used for comparison with the scintimammography results.
The majority of patients (64.4%) had clinically impalpable lesions with a mammogram diagnosis of microcalcifications, impalpable nodules, or focal asymmetry. Of the studied lesions, 87% were smaller or equal to 20 mm in diameter, and 22% had malignant histopathological findings. Scintigraphy with 99mTc-thymine had a sensitivity of 70%, a specificity of 85.7%, positive and negative predictive values of 58.3% and 90.9%, respectively, and an accuracy of 82.2%.
The results of this study are consistent with those previously reported by other authors. The good specificity and high negative predictive value of this technique and the absence of uptake in the heart indicate that it may be a promising complementary method in clinical practice and that it may contribute to reducing unnecessary benign biopsies.
乳腺 X 线摄影术已被确立为乳腺癌检测的金标准,而超声、磁共振成像、闪烁扫描和正电子发射断层扫描等影像学技术可能有助于提高其敏感性和特异性。本研究旨在使用乳腺闪烁扫描评估 99mTc-胸腺嘧啶在乳腺病变中的摄取情况。
共有 45 例患者纳入本研究。33 例(73%)患者接受了手术或经皮活检,提供了组织病理学数据。其余 12 例仍在接受监测的患者接受了临床检查和每两年一次的乳腺 X 线摄影检查,其随访时间至少为 3 年,该数据用于与闪烁成像结果进行比较。
大多数患者(64.4%)的临床触诊不到的病变,乳腺 X 线摄影检查诊断为微钙化、触诊不到的结节或局部不对称。研究中的病变中,87%的直径小于或等于 20mm,22%有恶性组织病理学发现。99mTc-胸腺嘧啶闪烁扫描的敏感性为 70%,特异性为 85.7%,阳性和阴性预测值分别为 58.3%和 90.9%,准确性为 82.2%。
本研究结果与其他作者先前的报告一致。该技术具有良好的特异性和较高的阴性预测值,且心脏无摄取,表明它可能是临床实践中一种有前途的补充方法,有助于减少不必要的良性活检。