Maurer A H, Caroline D F, Jadali F J, Manzone T A, Maier W P, Au F C, Schnall S F
Department of Diagnostic Imaging, Temple University Hospital, Philadelphia, Pennsylvania 19140, USA.
J Nucl Med. 1995 Sep;36(9):1696-700.
Previous studies with 201Tl and 99mTc-sestamibi (MIBI) have used large field of view (LFOV) cameras not optimized for breast imaging. The purpose of this study was to compare these agents and to determine if a small field of view (SFOV) camera designed to minimize the camera-to-breast distance could improve tumor detection.
A 28-cm (SFOV) camera was fitted with slant-hole and diverging collimators to perform craniocaudal scintigraphy for direct comparison with mammography. Of the 46 patients studied, 20 had 201Tl imaging alone and 26 had combined 201Tl and MIBI imaging. LFOV (40 cm) breast and axillary images also were obtained. Visual and quantitative analyses of tumor uptake were performed.
The SFOV camera with nonparallel collimation showed variable 201Tl and MIBI normal breast activity. This was partly due to significant scatter from cardiac and abdominal activity. Overall, 201Tl had a sensitivity of 53%, which was 67% for tumors > or = 1.5 cm and 20% for tumors < or = 1.5 cm. MIBI sensitivity was 90% (9/10) for lesions > or = 1.5 cm. Specificity was 93% for 201Tl and 83% for MIBI. There was no significant difference in 201Tl (1.76 +/- 0.55) and MIBI (1.82 +/- 0.95) tumor uptake ratios (p = 0.75).
Technetium-99m-MIBI was more sensitive than 201Tl for imaging lesions > or = 1.5 cm. Craniocaudal positioning minimized the camera-to-breast distance but did not increase 201Tl detection of tumors < 1.5 cm and increased background breast activity due to scatter.
先前使用铊 - 201（201Tl）和锝 - 99m - 甲氧基异丁基异腈（99mTc - sestamibi，MIBI）的研究采用的是未针对乳腺成像进行优化的大视野（LFOV）相机。本研究的目的是比较这些显像剂，并确定设计用于最小化相机与乳腺距离的小视野（SFOV）相机是否能提高肿瘤检测率。
一台28厘米（SFOV）相机配备倾斜孔和发散准直器，用于进行头足位闪烁扫描，以便与乳腺X线摄影直接比较。在研究的46例患者中，20例仅进行了201Tl显像，26例进行了201Tl和MIBI联合显像。还获取了LFOV（40厘米）的乳腺和腋窝图像。对肿瘤摄取进行了视觉和定量分析。
具有非平行准直的SFOV相机显示201Tl和MIBI在正常乳腺的活性存在差异。这部分是由于心脏和腹部活性产生的显著散射。总体而言，201Tl的灵敏度为53%，对于直径≥1.5厘米的肿瘤灵敏度为67%，对于直径≤1.5厘米的肿瘤灵敏度为20%。MIBI对于直径≥1.5厘米的病变灵敏度为90%（9/10）。201Tl的特异性为93%，MIBI的特异性为83%。201Tl（1.76±0.55）和MIBI（1.82±0.9
