| Breast cancer is the most common malignancy among women, and it is very important to detect and diagnosis earlier.Many imaging modalities have been used in evaluating breast cancer,the histopathology> fine needle aspiration cytology ^ x-ray mammograph^ ultrasound and MRI are the effective modalities for detection breast cancer, but these have known limitations?It is the focus recently with nuclear imaging to evaluate breast tumor, such as """Tc-MIBI, et al, have been suggested as radiopharmaceuticals with a great deal of promise in imaging breast tumor. The purpose of this study was to evaluate prospectively the sensitivity and specificity of """Tc-MIBI scintimammography in the differential palpable breast masses and the axillary lymph node involvement in breast cancer?Materials and methodsPatients Thirty four women with palpable breast masses,including 24 maliganants and 10 benighs.Age range from 28yr to 90yr(mean age 48.5 + 31.5yr ),The sizes of breast masses from 1.5 to 6.0cm^nean 3.5 + 1.7cm.Imaging All patients had the same "Tc-sestamibi breast imagingprotocol before be operated 1 week.There was no specific patient preparation,3Labeling and quality control of """Tc-MIBI were performed according to the manufacturers instructions(Jiangsu insititute nuclear medicine)and its labeling efficiency was always more than 95%.The 555mbq~750mbq (15~20mci) "mTc-MIBI was injected into an antecubital vein contralateral to the palpable breast lesion. The early and delay images were acquired at 15min and 1.5h after injection of the tracer.The imaging was performed using special designed imaging device made by ourselves.The patient should be lying prone in the device with bilateral breast placing in the center of holesjand with the arms were raised and the hands placed behind the patient,s head. Three planar views, right and left lateral and anterior views including both axillae were obtained. The acquisition counts should be reach 1000k. .The gama camera is TOSHIBA GCA 901 A,with a low-energy general collimator. A positive result was defined as a focalized area of increased uptake in eary and delay images in masses or axillary ;and a negitive result was defined as a no radioactivity increase or in the early images has mild increase but in the delay images is disappear or noted decrease. All images were direct readed on the computer .Results1 % 34 patients with breast mass,There were 22 patients """Tc-MIBI images positive ,and 12 images negitive.after surgery histopathologic diagnosis 24 were malignant, and other 10 were benign.2^ Using histopathologic diagnosis as the gold standard, there were 20 true-positive, 4 false-negra've in 24 malignants imaging. And there were 2 false-positives,8 true-negitive in 10 benigns.3^ The sensitivity of99mTc-MIBI images in diagnosis breast cancer was83.3%, and the specificity was 80.0% ,the positive and the negative predictive values were 90.9% and 66.7%,the accuracy was 82.4%.4> The sensitivity of scintimammography in detecting metastatic axillary lymph node was 80.0%, and the specificity was 92.9% ,the positive and the negative predictive values were 88.9% and 86.7%,the acuracy was 87.5%.5^ The relation between the positive ratio and tumor sizes :The tumor size range 5=20mm,the positive ratio was 40.0% ;the tumor size range 20mm~ 40mm and ^40mm,the positive ratio were 87.5% and 100.0%.Conclusion99mTc-MIBI images provides clinically valuable information on patients with palpable breast masses. "mTc-MIBI scintigraphy of breast can well differential between malignant and benign masses,but the sensitivity for lesions was related the tumor size in some degree.The method of "'"Tc-MIBI imaging is simple ,and is an effective means of detecting and localizing axillary lymph node involvement, and it would be very helpful to working out surgery program and predicting the prognosis for the patients. |
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