原发性乳腺癌腋窝转移性淋巴结的锝-99m-甲氧基异丁基异腈显像

Metastatic axillary lymph node technetium-99m-MIBI imaging in primary breast cancer.

作者信息

Taillefer R, Robidoux A, Turpin S, Lambert R, Cantin J, Léveillé J

机构信息

Department of Nuclear Medicine, Hopital Hôtel-Dieu De Montréal, Canada.

出版信息

J Nucl Med. 1998 Mar;39(3):459-64.

PMID:9529292

Abstract

UNLABELLED

Technetium-99m-MIBI scintimammography has been shown to be useful in the detection of primary breast cancer. The purpose of this study was to evaluate the potential role of scintimammography in detecting axillary lymph node involvement in patients undergoing scintimammography to detect primary breast cancer.

METHODS

A group of 100 women with breast cancer who were scheduled for a Level I-II axillary dissection were prospectively studied. Scintimammography was performed in all patients before histopathologic confirmation of breast cancer. Two lateral (prone imaging) views and one anterior (supine) planar thoracic view were obtained 10-15 min after the injection of 25-30 mCi 99mTc-MIBI (10 min/view) by using a special breast positioning device (foam cushion) placed over the imaging table. Both of the axilla were included in the field-of-view. Two experienced blinded observers reviewed all cases both from films and from the computer screen with contrast adjustment when needed. The site of intravenous injection of 99mTc-MIBI was known to the interpreters in order to avoid reading any false-positive uptake in the axilla ipsilateral to the injection site.

RESULTS

A total of 52 patients had no axillary lymph node involvement (611 negative nodes) while 48 patients had at least one axillary lymph node with metastatic involvement (180/502 positive nodes). The sensitivity of scintimammography in detecting metastatic axillary lymph node involvement was 79.2% (38/48), and the specificity was 84.6% (44/52). The positive and the negative predictive values were 82.6% (38/46) and 81.5% (44/54), respectively.

CONCLUSION

This study shows that scintimammography has good diagnostic accuracy for detecting axillary lymph node involvement in patients with breast cancer. This information should be added to the result of standard scintimammography, which requires very minor modifications in order to simultaneously evaluate both of the axilla.

摘要

未标注

锝-99m-甲氧基异丁基异腈乳腺闪烁显像已被证明在原发性乳腺癌的检测中有用。本研究的目的是评估乳腺闪烁显像在接受乳腺闪烁显像以检测原发性乳腺癌的患者中检测腋窝淋巴结受累情况的潜在作用。

方法

前瞻性研究了一组计划进行Ⅰ-Ⅱ级腋窝清扫的100例乳腺癌女性患者。所有患者在乳腺癌组织病理学确诊前均进行了乳腺闪烁显像。通过使用置于成像台上的特殊乳腺定位装置（泡沫垫），在注射25-30mCi 99mTc-MIBI后10-15分钟（每次采集10分钟）获得两个侧位（俯卧位成像）视图和一个前位（仰卧位）胸部平面视图。两个腋窝均包括在视野内。两名经验丰富的不知情观察者对所有病例进行了复查，必要时通过调整对比度在胶片和电脑屏幕上进行观察。解释者知晓99mTc-MIBI的静脉注射部位，以避免将注射部位同侧腋窝的任何假阳性摄取误判为转移灶。

结果

共有52例患者无腋窝淋巴结受累（611个阴性淋巴结），而48例患者至少有一个腋窝淋巴结有转移受累（180/502个阳性淋巴结）。乳腺闪烁显像检测转移性腋窝淋巴结受累的敏感性为79.2%（38/48），特异性为84.6%（44/52）。阳性预测值和阴性预测值分别为82.6%（38/46）和81.5%（44/54）。