1 Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
2 Biomedical Photonic Imaging Group, MIRA Institute, University of Twente, Enschede, The Netherlands.
AJR Am J Roentgenol. 2017 Dec;209(6):1367-1373. doi: 10.2214/AJR.17.18083. Epub 2017 Apr 5.
The purpose of this study is to evaluate a new device using molecular breast imaging (MBI) for Tc-sestamibi-guided stereotactic lesion localization as a complementary biopsy tool.
From December 2012 to May 2016, a total of 38 consecutive women (mean age, 59 years; range, 41-77 years) underwent Tc-sestamibi-guided biopsy using a new MBI-based device and were retrospectively reviewed. The biopsy modality used five steps: stereotactic localization of the Tc-sestamibi-avid lesion, calculation of coordinates of the lesion location using dedicated software, placement of the needle, verification of the correct needle position, and tissue sampling with a vacuum-assisted device followed by placement of a radiologic marker at the biopsy site and ex vivo measurement of the biopsy specimens.
The procedure was technically successful in all 38 lesions. In all cases, biopsy samples were radioactive and adequate for histopathologic analysis. Nineteen lesions (50%) were found to be malignant, and the remaining lesions were found to be benign. The mean procedure time was 71 minutes (range, 44-112 minutes). The radiologic marker was successfully deployed in 37 lesions (97%). Two hematomas and three vasovagal reactions were observed.
Technetium-99m sestamibi-guided biopsy performed using a dedicated MBI-based device is technically feasible and represents a valuable complementary biopsy tool in breast lesion diagnosis.
本研究旨在评估一种新型的分子乳腺成像（MBI）设备在 Tc- sestamibi 引导下的立体定向病变定位中的应用，将其作为一种补充性活检工具。
2012 年 12 月至 2016 年 5 月，共有 38 例连续女性（平均年龄 59 岁；范围 41-77 岁）接受了基于新型 MBI 设备的 Tc-sestamibi 引导下的活检，并进行了回顾性分析。活检模式采用五个步骤：Tc-sestamibi 摄取病变的立体定向定位、使用专用软件计算病变位置的坐标、放置针头、验证正确的针头位置、使用真空辅助装置进行组织取样，然后在活检部位放置放射性标记物，并对活检标本进行离体测量。
所有 38 个病变的操作均取得了技术成功。在所有病例中，活检样本均具有放射性，足以进行组织病理学分析。19 个病变（50%）为恶性，其余病变为良性。平均手术时间为 71 分钟（范围 44-112 分钟）。37 个病变（97%）成功放置了放射性标记物。观察到 2 例血肿和 3 例血管迷走神经反应。
使用专用 MBI 设备进行 Tc-99m sestamibi 引导的活检在技术上是可行的，是一种有价值的乳腺病变诊断补充性活检工具。
