99mTc-3PRGD2 Scintimammography in Palpable and Nonpalpable Breast Lesions
99mTc-3PRGD2 Scintimammography in Palpable and Nonpalpable Breast Lesions
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DOI：
10.2310/7290.2014.00010
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发表时间：
2014-07-01
影响因子：
2.8
通讯作者：
Ma, Qingjie
中科院分区：
文献类型：
--
作者：
Liu, Lin;Song, Yan;Ma, Qingjie
本研究的目的是探讨Tc-99 m-3（聚乙二醇，PEG）4-RGD（2）（Tc-99 m-3 PRGD（2））乳腺X线摄影（SMM）在可触及或不可触及乳腺病变患者中的诊断性能，并将SMM与乳腺X线摄影进行比较，以评估SMM在乳腺癌检测中可能的增量价值。我们还研究了α（v）β（3）在恶性和良性乳腺病变中的表达。本研究纳入了94例患者的110处病变。由专门的影像放射科医师根据乳腺成像报告和数据系统（BI-RADS）对乳房X线照片进行评价。在注射Tc-99 m-3 PRGD后1小时进行俯卧SMM（2）。由两名经验丰富的核医学医生使用三点系统独立解释闪烁图像，并计算Kappa值以确定阅片者之间的一致性。McNemar检验用于比较SMM和乳腺X线摄影的灵敏度、特异性和准确性。乳腺癌检测的诊断价值进行了评估，为每个病变。免疫组化检测整合素avb 3的表达。组织学检查显示恶性病变46例，良性病变64例。SMM的总体敏感性、特异性、准确性、阳性预测值和阴性预测值分别为83%、73%、77%、69%和85%。两名评审员之间的Kappa值为0.63。在评价乳腺整体病变方面，SMM的诊断价值高于钼靶摄影。当SMM和乳腺X线摄影结果结合时，60%的假阴性乳腺X线摄影结果被SMM归类为真阳性结果时，灵敏度达到91%。整合素avb 3表达阳性鉴定使用SMM成像。SMM是一种很有前途的工具，可以避免不必要的活检时，除了乳房X线摄影，并可用于图像avb 3表达在乳腺癌具有良好的图像质量。
The aim of this study was to explore the diagnostic performance of Tc-99m-3(poly-(ethylene glycol), PEG) 4-RGD(2) (Tc-99m-3PRGD(2)) scintimammography (SMM) in patients with either palpable or nonpalpable breast lesions and compare SMM to mammography to assess the possible incremental value of SMM in breast cancer detection. We also investigated the alpha(v)beta(3) expression in malignant and benign breast lesions. Ninety-four patients with 110 lesions were included in this study. Mammograms were evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) by a specialized imaging radiologist. Prone SMM was performed 1 hour after injection of Tc-99m-3PRGD(2). Scintigraphic images were interpreted independently by two experienced nuclear medicine physicians using a three-point system, and the kappa value was calculated to determine the interreader agreement. The McNemar test was used to compare SMM and mammography with respect to sensitivity, specificity, and accuracy. Diagnostic values for breast cancer detection were evaluated for each lesion. Immunohistochemistry was performed to evaluate integrin avb3 expression. Histopathology revealed 46 malignant lesions and 64 benign lesions. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SMM were 83%, 73%, 77%, 69%, and 85%, respectively. The kappa value between the two reviewers was 0.63. The diagnostic values of SMM were higher than those of mammography in evaluating overall breast lesions. A sensitivity of 91% was achieved when SMM and mammography results were combined with 60% of all false-negative mammography findings classified as true-positive results by SMM. Integrin avb3 expression was positively identified using SMM imaging. SMM is a promising tool to avoid unnecessary biopsies when used in addition to mammography and can be used to image avb3 expression in breast cancer with good image quality.