بررسی ارزش تشخیصی اسکن 99mTc-MIBI (Scintimammography) در بدخیمی های پستان

The breast cancer is common in females.Early detection with safe , convenient , noninvasive and accessible diagnostic tools are important. X- ray mammography is still the first choice imaging for breast cancer, but has low specificity and limited value in dense breast and surgically scarred breasts. In recent years , MIBI scintimammography has been used for this purpose. The aim of this study was to determine diagnostic value of prone lateral 99mTc-MIBI scintigraphy in detection of primary breast cancer in    patients with breast lesions.           We evaluated 55 patients with breast lesions and/or suspicious mammographic findings with MIBI scintimammography. In all patients , the diagnosis was established by pathology. Pattern of MIBI uptake and ratio of lesion to normal tissue uptake was recorded. All lesions with focal uptake and T/N ratio of more than 1.31 were considered as positive. Absence of  focal activity or diffuse uptake either unilaterally or bilaterally were considered negative for malignancy. Focal uptake with T/N ratio of 1.01-  1.30 was equivocal in MIBI scan. Mammographic and sonographic findings were classified as negative ( normal or benign) , equivocal and Positive (suspecious for malignancy or strongly malignant).           Of 55 patients , 10 had cancer in pathologic examination. The MIBI scan detected all of the 10 cancerous lesions. X-mammography was positive in 6 of 10 patients and was negative or equivocal in 3 of them. In this study the MIBI breast scintimammography showed sensitivity and specificity of 100%    and 95.4%.           With respect to the limitations of X-ray mammography particularly in the young females , dense breasts and surgically scarred breasts , and low specificity of it , MIBI scan can be used as complementary imaging to the mammography and sonography in the evaluation of the breast lesions.