Breast scintigraphy evaluation with technetium 99m sestamibi.
Date
1998
Authors
Geyer, René
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Forty (40) female patients with breast masses underwent Technetium 99m Sestamibi
scintigraphy in order to evaluate its usefulness in differentiating benign from malignant breast
disease and to compare scintigraphy to mammography. Informed consent was obtained from
each patient. Scintigraphy consisted of anterior chest and lateral and oblique breast planar
images, obtained 5 minutes after intravenous injection of 20 rnecuries (740 MBq)
Technetium 99m Sestamibi. Eleven (11) of the 40 patients also had Technetium 99m
Methylene Diphosponate breast scintigraphy for comparison. Four nuclear medicine physicians
of who three also graded the MDP images performed grading of the Sestamibi scintigraphic
images. The grading method, although focussing on the absence (0) or presence (>0) of
uptake of isotope, was also designed for comparison of the Sestamibi and MDP images.
Statistical analysis showed good correlation between observer grading. Breast scintigraphy
was compared to mammography in 27 ofthe 40 patients.
Of the 26 malignant breast masses confirmed on histology, 19 were positively identified on
Sestamibi scanning giving a sensitivity of 73%, 2 results were inconclusive (grading (0·1)
and 5 had a grading 0, of the 8 patients with confirmed lymph node metastases, only 2 were
positive on the Sestamibi scans, with 1 inconclusive result. Of the 19 benign breast masses, 9
were visible on Sestamibi scans with additional 3 inconclusive results (grading of 0-1).
Statistical analysis showed no significant difference in the Sestamibi and MDP grading. In
comparison to mammography, breast scintigraphy was less accurate in distinguishing benign
from malignant breast masses. Mammography identified 85.7% of the malignant breast masses
and 72.7% of the benign breast masses. Sestamibi scintigraphy identified 76.2% of the
malignant breast masses and only 36.4% of the benign breast masses.
Description
A research report submitted to the Faculty of Medicine, University of the Witwatersrand,
Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science in Medicine in Nuclear Medicine.
Keywords
Breast Diseases diagnosis., Breast Diseases radionuclide imaging.