Shariati Farzaneh, Aryana Kamran, Fattahi Asiehsadat, Forghani Mohammad N, Azarian Azita, Zakavi Seyed R, Sadeghi Ramin, Ayati Narjes, Sadri Keyvan
aNuclear Medicine Research Center bMinimally Invasive and Endoscopic Surgery Research Center cDepartment of Radiology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Nucl Med Commun. 2014 Jun;35(6):620-5. doi: 10.1097/MNM.0000000000000112.
In this study, we evaluated the diagnostic accuracy of (99m)Tc-bombesin scintigraphy for differentiation of benign from malignant palpable breast lesions. (99m)Tc-Bombesin is a tracer with high affinity for gastrin-releasing peptide receptor, which is overexpressed on a variety of human tumors including breast carcinoma.
We examined 33 consecutive women who were referred to our center with suspicious palpable breast lesions but had no definitive diagnosis in other imaging procedures. A volume of 370-444 MBq of (99m)Tc-bombesin was injected and dynamic 1-min images were taken for 20 min immediately after injection in anterior view. Thereafter, two static images in anterior and prone-lateral views were taken for 5 min. Finally, single-photon emission computed tomography images were taken for each patient. Definitive diagnosis was based on biopsy and histopathological evaluation.
The scan findings were positive in 19 patients and negative in 11 on visual assessment of the planar and single-photon emission computed tomography images. Pathologic examination confirmed breast carcinoma in 12 patients with positive scans and benign pathology for 18 patients. The overall sensitivity, specificity, negative and positive predictive values, and accuracy of this radiotracer for diagnosis of breast cancer were 100, 66.1, 100, 63, and 76%, respectively. Semiquantitative analysis improved the specificity of the visual assessment from 66 to 84%.
Our study showed that (99m)Tc-bombesin scintigraphy has a high sensitivity and negative predictive value for detecting malignant breast lesions, but the specificity and positive predictive value of this radiotracer for differentiation of malignant breast abnormalities from benign ones are relatively low.
在本研究中，我们评估了（99m）锝-蛙皮素闪烁扫描术对可触及乳腺病变良恶性鉴别的诊断准确性。（99m）锝-蛙皮素是一种对胃泌素释放肽受体具有高亲和力的示踪剂，该受体在包括乳腺癌在内的多种人类肿瘤中过表达。
我们检查了33例连续转诊至本中心的女性患者，她们有可触及的可疑乳腺病变，但在其他影像学检查中未得到明确诊断。注射370 - 444 MBq的（99m）锝-蛙皮素，注射后立即在前位进行动态1分钟图像采集，共采集20分钟。此后，在前位和俯卧侧位采集两张静态图像，采集时间为5分钟。最后，为每位患者进行单光子发射计算机断层扫描图像采集。最终诊断基于活检和组织病理学评估。
在平面和单光子发射计算机断层扫描图像的视觉评估中，扫描结果在19例患者中为阳性，11例为阴性。病理检查证实，扫描阳性的12例患者为乳腺癌，18例患者为良性病变。这种放射性示踪剂诊断乳腺癌的总体敏感性、特异性、阴性和阳性预测值以及准确性分别为100%、66.1%、100%、63%和76%。半定量分析将视觉评估的特异性从66%提高到了84%。
我们的研究表明，（99m）锝-蛙皮素闪烁扫描术在检测恶性乳腺病变方面具有较高的敏感性和阴性预测值，但这种放射性示踪剂在鉴别乳腺恶性异常与良性异常方面的特异性和阳性预测值相对较低。
