Department of Quantum Cancer Therapy, Research Center for Nuclear Physics, Osaka University, Osaka, Japan; Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan; Institute for Radiation Sciences, Osaka University, Osaka, Japan; Immunology Frontier Research Center, Osaka University, Osaka, Japan.
Semin Nucl Med. 2022 Sep;52(5):619-627. doi: 10.1053/j.semnuclmed.2022.02.005. Epub 2022 Mar 25.
In the management of patients with breast cancer (BC), a mammography contributed to screen an early-stage patient, to plan a therapy strategy, to evaluate a therapy outcome, to detect a recurrence, and to reduce a mortality. Currently, various imaging modalities, such as CT, MR, Ultrasound (US), SPECT/CT, PET/CT, PET/MR have been utilized for the management of BC patients. In order to overcome a limited spatial resolution and sensitivity of whole-body systems in nuclear medicine imaging, dedicated breast imaging modalities were developed. One is a gamma imaging system with single/dual head scintillation detectors or semiconductor detectors associated with light compression device for breast parenchyma. Radiopharmaceutical for the gamma imaging is Tc-sestamibi. Another is a positron imaging system with opposite-type panel detectors and ring-shaped type detectors. Radiopharmaceutical for positron imaging is F-fluorodeoxyglucose. The breast-specific gamma and positron imaging systems were utilized mainly to detect small lesions less than 1 cm in diameter especially in patients with dense breast, to evaluate an effect of preoperative neo-adjuvant therapy, to plan surgical procedures (conservative-surgery vs mastectomy), and to detect a recurrence. By combining higher sensitivity and spatial resolution scanners with new radiopharmaceuticals, an information on molecular-level pathology of BC is increasingly available in an individual patient. This article reviewed clinical impact and future perspective of this field.
在乳腺癌 (BC) 患者的管理中，乳腺 X 线摄影有助于筛查早期患者，制定治疗策略，评估治疗效果，检测复发，降低死亡率。目前，各种成像方式，如 CT、MR、超声 (US)、SPECT/CT、PET/CT、PET/MR 已用于 BC 患者的管理。为了克服核医学成像中全身系统空间分辨率和灵敏度的局限性，开发了专门的乳腺成像方式。一种是带有光压缩装置的单/双头闪烁探测器或半导体探测器的伽马成像系统，用于乳腺实质。伽马成像的放射性药物是 Tc-sestamibi。另一种是带有对置式面板探测器和环形探测器的正电子成像系统。正电子成像的放射性药物是 F-氟脱氧葡萄糖。乳腺专用伽马和正电子成像系统主要用于检测直径小于 1 厘米的小病灶，特别是在致密乳腺患者中，评估术前新辅助治疗的效果，规划手术程序（保乳手术与乳房切除术），以及检测复发。通过将具有更高灵敏度和空间分辨率的扫描仪与新型放射性药物相结合，可在个体患者中获得更多关于 BC 分子水平病理学的信息。本文综述了该领域的临床影响和未来展望。
