Lee Hyo Sang, Ko Beom Seok, Ahn Sei Hyun, Son Byung Ho, Lee Jong Won, Kim Hee Jeong, Yu Jong Han, Kim Sung-Bae, Jung Kyung Hae, Ahn Jin-Hee, Cha Joo Hee, Kim Hak Hee, Lee Hee Jin, Song In-Hye, Gong Gyungyub, Park Seol-Hoon, Lee Jong Jin, Moon Dae Hyuk
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
Breast Cancer Res Treat. 2014 May;145(1):91-100. doi: 10.1007/s10549-014-2920-z. Epub 2014 Mar 27.
To evaluate the diagnostic performance of breast-specific gamma imaging (BSGI) in the assessment of residual tumor after neoadjuvant chemotherapy (NAC) in breast cancer patients, female breast cancer patients who underwent NAC, preoperative (99m)Tc-sestamibi BSGI, and subsequent definitive breast surgery were enrolled retrospectively. The accuracy of BSGI in the assessment of residual tumor presence and residual tumor size was evaluated and compared to that of magnetic resonance imaging (MRI) using pathology results as the gold standard. The sensitivity and specificity of BSGI for residual tumor detection in 122 enrolled patients were 74.0 and 72.2 %, respectively, and were comparable to those of MRI (81.7 and 72.2 %; P > 0.100). The residual tumor size was significantly underestimated by BSGI in the luminal subtype (P = 0.008) and by MRI in the luminal (P < 0.001) and HER2 subtypes (P = 0.032), with a significantly lesser degree of underestimation by BSGI than MRI in both subtypes. In the triple-negative subtype, both BSGI and MRI generated accurate tumor size measurements. The residual cellularity of triple-negative tumors was significantly higher than that of the non-triple-negative tumors (P = 0.017). The diagnostic performance of BSGI in the assessment of residual tumor is comparable to that of MRI in breast cancer patients. The assessment of residual tumor extent by BSGI depends on the molecular subtype, but BSGI may be more accurate than MRI. Underestimation of tumor size in the luminal and/or HER2 subtypes by BSGI and MRI may be due to low-residual cellularity.
为评估乳腺特异性γ成像（BSGI）在乳腺癌患者新辅助化疗（NAC）后残余肿瘤评估中的诊断性能，我们回顾性纳入了接受NAC、术前（99m）Tc-甲氧基异丁基异腈BSGI检查以及随后进行确定性乳房手术的女性乳腺癌患者。以病理结果作为金标准，评估了BSGI在评估残余肿瘤存在和残余肿瘤大小方面的准确性，并与磁共振成像（MRI）进行比较。在122例纳入患者中，BSGI检测残余肿瘤的敏感性和特异性分别为74.0%和72.2%，与MRI相当（81.7%和72.2%；P>0.100）。在管腔亚型中，BSGI显著低估了残余肿瘤大小（P=0.008），在管腔亚型（P<0.001）和HER2亚型（P=0.032）中，MRI也显著低估了残余肿瘤大小，在这两种亚型中，BSGI的低估程度均明显低于MRI。在三阴性亚型中，BSGI和MRI均能准确测量肿瘤大小。三阴性肿瘤的残余细胞密度显著高于非三阴性肿瘤（P=0.017）。BSGI在评估残余肿瘤方面的诊断性能与乳腺癌患者中的MRI相当。BSGI对残余肿瘤范围的评估取决于分子亚型，但BSGI可能比MRI更准确。BSGI和MRI对管腔和/或HER2亚型肿瘤大小的低估可能是由于残余细胞密度低。
