Ma Qingjie, Chen Bin, Gao Shi, Ji Tiefeng, Wen Qiang, Song Yan, Zhu Lei, Xu Zheli, Liu Lin
China-Japan Union Hospital, Jilin University, Changchun, China.
State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China.
PLoS One. 2014 Sep 24;9(9):e108349. doi: 10.1371/journal.pone.0108349. eCollection 2014.
To compare the potential application of (99m)Tc-3P-Arg-Gly-Asp ((99m)Tc-3P4-RGD2) scintimammography (SMM) and (99m)Tc-methoxyisobutylisonitrile ((99m)Tc-MIBI) SMM for the differentiation of malignant from benign breast lesions.
Thirty-six patients with breast masses on physical examination and/or suspicious mammography results that required fine needle aspiration cytology biopsy (FNAB) were included in the study. (99m)Tc-3P4-RGD2 and (99m)Tc-MIBI SMM were performed with single photon emission computed tomography (SPECT) at 60 min and 20 min respectively after intravenous injection of 738 ± 86 MBq radiotracers on a separate day. Images were evaluated by the tumor to non-tumor localization ratios (T/NT). Receiver operating characteristic (ROC) curve analysis was performed on each radiotracer to calculate the cut-off values of quantitative indices and to compare the diagnostic performance for the ability to differentiate malignant from benign diseases.
The mean T/NT ratio of (99m)Tc-3P4-RGD2 in malignant lesions was significantly higher than that in benign lesions (3.54 ± 1.51 vs. 1.83 ± 0.98, p<0.001). The sensitivity, specificity, and accuracy of (99m)Tc-3P4-RGD2 SMM were 89.3%, 90.9% and 89.7%, respectively, with a T/NT cut-off value of 2.40. The mean T/NT ratio of (99m)Tc-MIBI in malignant lesions was also significantly higher than that in benign lesions (2.86 ± 0.99 vs. 1.51 ± 0.61, p<0.001). The sensitivity, specificity and accuracy of (99m)Tc-MIBI SMM were 87.5%, 72.7% and 82.1%, respectively, with a T/NT cut-off value of 1.45. According to the ROC analysis, the area under the curve for (99m)Tc-3P4-RGD2 SMM (area = 0.851) was higher than that for (99m)Tc-MIBI SMM (area = 0.781), but the statistical difference was not significant.
(99m)Tc-3P4-RGD2 SMM does not provide any significant advantage over the established (99m)Tc-MIBI SMM for the detection of primary breast cancer. The T/NT ratio of (99m)Tc-3P4-RGD2 SMM was significantly higher than that of (99m)Tc-MIBI SMM. Both tracers could offer an alternative method for elucidating non-diagnostic mammograms.
比较（99m）锝-3P-精氨酸-甘氨酸-天冬氨酸（（99m）Tc-3P4-RGD2）乳腺闪烁显像（SMM）和（99m）锝-甲氧基异丁基异腈（（99m）Tc-MIBI）SMM在鉴别乳腺良恶性病变方面的潜在应用价值。
本研究纳入36例经体格检查发现乳腺肿块和/或乳腺钼靶检查结果可疑且需行细针穿刺细胞学活检（FNAB）的患者。在不同日期静脉注射738±86 MBq放射性示踪剂后，分别于60分钟和20分钟行单光子发射计算机断层扫描（SPECT），进行（99m）Tc-3P4-RGD2和（99m）Tc-MIBI SMM检查。通过肿瘤与非肿瘤定位比值（T/NT）对图像进行评估。对每种放射性示踪剂进行受试者操作特征（ROC）曲线分析，以计算定量指标的截断值，并比较鉴别良恶性疾病的诊断性能。
（99m）Tc-3P4-RGD2在恶性病变中的平均T/NT比值显著高于良性病变（3.54±1.51对1.83±0.98，p<0.001）。（99m）Tc-3P4-RGD2 SMM的敏感性、特异性和准确性分别为89.3%、90.9%和89.7%，T/NT截断值为2.40。（99m）Tc-MIBI在恶性病变中的平均T/NT比值也显著高于良性病变（2.86±0.99对1.51±0.61，p<0.001）。（99m）Tc-MIBI SMM的敏感性、特异性和准确性分别为87.5%、72.7%和82.1%，T/NT截断值为1.45。根据ROC分析，（99m）Tc-3P4-RGD2 SMM的曲线下面积（面积=0.851）高于（99m）Tc-MIBI SMM（面积=0.781），但差异无统计学意义。
在原发性乳腺癌检测方面，（99m）Tc-3P4-RGD2 SMM相比已有的（99m）Tc-MIBI SMM并无显著优势。（99m）Tc-
