Radionuclide imaging of breast cancer: experience of FSBI “N.N. Petrov National Medical Research Centre of Oncology” of the Ministry of Healthcare of Russian Federation

Abstract. Breast cancer is one of the most common malignant neoplasms among women nowadays. Timely diagnosis is the basis for effective and successful treatment of this disease. The existing classical methods of X-ray examination (MG, ultrasound, MRI) play a major role in the detection of breast cancer, but in some cases, the diagnosis of breast cancer can be difficult. Therefore, diagnostic performance of scintimammography with specialized gamma camera called molecular breast imaging (MBI) is now of particular clinical interest.
Materials and methods. 312 patients with a preliminary clinical diagnosis of breast cancer were examined in the department of radionuclide diagnostics of N.N. Petrov Research Center of Oncology. They underwent scintimammography (MBI) with a specialized gamma camera manufactured by GE (Discovery 750b). Images of both breasts were obtained 15 min after intravenous injection of 500 MBq activity of 99mTc-MIBI. The foci of moderate and intensive radiopharmaceutical accumulation in breast were considered as a sign of a tumor. The diagnostic performance of MBI and the sensitivity in detection of various biological subtypes of cancer were calculated by comparing with the results of morphological and immunohistochemically studies.
Results. The sensitivity, specificity and accuracy of the MBI in the diagnostics of breast cancer were 88, 75 and 87%, respectively. Sensitivity of this method in detection of different biological subtypes ranged from 89% to 95% with lowest performance found in luminal A subtype.
Conclusion. Scintimammography (MBI) is an informative way of breast cancer diagnostics. The revealed differences in the sensitivity of the method in patients with different biological subtypes of breast cancer confirm the need for further study of this topic.

1. Merabishvili V.M. Malignant neoplasms in the Northwestern Federal District of Russia / Ed. prof. Belyaev A.M. St. Petersburg, 2018: 16–17. (In Russian)

2. Halperin C.E. Principles and Practice of Radiation oncology. 6th ed. Halperin C.E. et al. Philadelphia: Wolters Kluer-Lippincot Williams&Wilkins, 2013: 568–590.

3. Rink P. Magnetic resonance in medicine / Ed. prof. Rink P.: Translate from English. Oxford: Blackwell, Scientific Publications, 1995: 4–29. ISNB 5-9231-0320-6 (In Russian)

4. Prokop M. Spiral and multilayer computed tomography. In 3 vol. Vol. 2. Textbook / Prokop M., Galanski M.: Translate from English. Zubarev A.V. and Shotemor Sh.Sh. M: MEDpress-inform, 2006–2007: 629–631. ISNB 978-5-98322-739-2 (In Russian)

5. Kanaev S.V., Novikov S.N., Zotova O.V., Girshovich M.M., Zhukova L.A., Semiglazov V.F., Krivorotko P.V., Ivanov V.G. Prospects for the use of nuclear medicine methods in patients with breast cancer. Problems of oncology. 2009: 55 (61): 661–670. (In Russian)

6. Narkevich B.Ya., Kostylev V.A. Physical foundations of nuclear medicine. M.: AMF-Press, 2001: 59. (In Russian)

7. Krylov A.S., Ryzhkov A.D., Shiryaev S.V., Goncharov M.O., Krylova M. A., Komanovskaya D.A., Bilik M.E., Kaspshik S.M., Mikhailova E.V., Stanyakina E.E., Zhukov G.A. SPECT/CT with 99m Tc-technetrile in the diagnosis of malignant tumors of the head and neck in children. Medical Radiology and Radiation Safety. 2020; 65 (1): 27–36. http://doi.org/10.12737/1024-6177-2020-65-1-27-36 (In Russian)

8. Chernaya A.V., Kanaev S.V., Novikov S.N., Krzhivitsky P.I., Krivorotko P.V., Zhukova L.A., Busko E.A. Diagnostic significance of mammography and mammoscintigraphy with 99m Tc-MIBI in detecting minimal breast cancer. Problems of oncology. 2017; 63 (2): 274–280. (In Russian)

9. Goldsmith S.J., Parsons W., Guiberteau M.J. et al. SNM Practice Guideline for Breast Scintigraphy with Breast-Specific g-Cameras 1.0. J. Nucl. Med. Technol. 2010; 38: 219–224. https://doi.org/10.2967/jnmt.110.082271

10. Titskaya A.A., Chernov V.I., Slonimskaya E.M., Sinilkin I.G., Zelchan R.V. Mammoscintigraphy with 99m Tc-MIBI in the diagnosis of breast cancer. Siberian Medical Journal. 2010; 25(4): 92–95. (In Russian)

11. Chernaya A.V., Krzhivitsky P.I., Busko E.A., Krivorotko P.V., Artemyeva A.S., Popova N.S., Danilov V.V., Semiglazov V.F., Novikov S.N., Kanaev S.V. The role of digital mammography, mammoscintigraphy with 99m Tc-methoxyisobutyl isonitrile (MIBI) and ultrasound in the diagnosis of multicentric breast cancer. Tumors of the Female Reproductive System. 2019; 15 (4): 12–22. (In Russian)

12. Velichko S.A., Slonimskaya E.M., Frolova I.G., Bukharin D.G., Doroshenko A.V. A method for predicting “small” forms of breast cancer against the background of fibrocystic disease. Bulletin of Siberian Medicine. 2017; 16 (1): 13–19. (In Russian)

13. Sun Y., Wei W., Yang H.W. et al. Clinical usefulness of breast-specific gamma imaging as an adjunct modality to mammography for diagnosis of breast cancer: A systemic review and meta-analysis. Eur. J. Nucl. Med. Mol. Imaging. 2013; 40 (3): 450–463.

14. Cwikla J.B., Buscombe J.R., Kolasinska A.D. et al. Correlation between uptake of 99m Tc-sestamibi and prognostic faktors of breast cancer. Anticancer Res. 1999; 19: 2299–2304.

15. Spanu A., Sanna D., Chessa F. et al. The usefulness of Tc-99m-tetrofosmin SPECT/CT in the detection of residual tumors and axillary lymph node metastases in breast cancer patients following neoadjuvant therapy. Clin. Nuclear Med. 2011; 36 (11): 997–1002.

16. Kim B.S. Usefulness of breast-specic gamma imaging as an adjunct modality in breast cancer patients with dense breast: a comparative study with MRI. Ann. Nucl. Med. 2012; 26: 131–137.

17. Krzhivitsky P.I., Novikov S.N., Kanaev S.V., Klitsenko O.А., Iliin N.D., Popova N.S., Ponomareva O.I., Chernaya А.V., Trufanova E.S., Krivorotko P.V. SPECT-CT in the diagnosis of metastatic lesions of the lymph nodes in patients with breast cancer. Problems of Oncology. 2017: 63 (2): 261–273. (In Russian)

18. Novikov S.N., Krivorotko P.V., Kanaev S.V. et al. Combination of Breast Scintigraphy and Ultrasound is Promising Tool for Diagnosis and Staging of Breast Cancer. Eur. J. Cancer. 2012; 48 (Suppl. 1): 612.