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Vukomanovic V, Matovic M, Djukic A, Ignjatovic V, Vuleta K, Djukic S, Simic Vukomanovic I. THE ROLE OF TUMOR-SEEKING RADIOPHARMACEUTICALS IN THE DIAGNOSIS AND MANAGEMENT OF ADRENAL TUMORS. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 16:316-323. [PMID: 33363653 DOI: 10.4183/aeb.2020.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Context The variety of tumor-seeking radiopharmaceuticals, which are currently in clinical use, may have a potential role as imaging agents for adrenal gland tumors, due to physiological characteristics of this organ. Objective The purpose of this study was to evaluate the diagnostic potential of 99mTc-HYNIC-TOC, 99mTc(V)-DMSA, and 99mTc-MIBI in the assessment of adrenal tumors, by correlating with imaging findings and histopathologic results. Design The research is designed as a cross-sectional prospective study. Patients and method The study included 50 patients with adrenal tumors (19 hormone-secreting and 31 nonfunctioning) and 23 controls without adrenal involvement. In all patients, single-photon emission computed tomography (SPECT) was performed, using qualitative and semiquantitative analysis. The tumor to non-tumor tracer uptake was conducted by using a region-of-interest technique. Adrenal to background (A/B) ratio was calculated in all cases. Results 99mTc-HYNIC-TOC scintigraphy showed a high statistical significance between A/B ratios, while other two tracers resulted in a lower sensitivity, specificity and accuracy. Futhermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumors (the receiver-operating-characteristic curve analysis, A/B ratio cut-off value of 8.40). Conclusion A semiquantitative SPECT analysis showed that 99mTc-HYNIC-TOC is a highly sensitive tumor-seeking agent for the accurate localization of adrenal tumors.
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Affiliation(s)
- V Vukomanovic
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia.,Department of Nuclear Medicine and Oncology, Kragujevac, Serbia
| | - M Matovic
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia
| | - A Djukic
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia.,Department of Pathophysiology, Kragujevac, Serbia
| | - V Ignjatovic
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia.,Department of Nuclear Medicine and Oncology, Kragujevac, Serbia
| | - K Vuleta
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia
| | - S Djukic
- Department of Internal Medicine, Kragujevac, Serbia
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Lima ZS, Ebadi MR, Amjad G, Younesi L. Application of Imaging Technologies in Breast Cancer Detection: A Review Article. Open Access Maced J Med Sci 2019; 7:838-848. [PMID: 30962849 PMCID: PMC6447343 DOI: 10.3889/oamjms.2019.171] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/16/2019] [Accepted: 02/17/2019] [Indexed: 12/12/2022] Open
Abstract
One of the techniques utilised in the management of cancer in all stages is multiple biomedical imaging. Imaging as an important part of cancer clinical protocols can provide a variety of information about morphology, structure, metabolism and functions. Application of imaging technics together with other investigative apparatus including in fluids analysis and vitro tissue would help clinical decision-making. Mixed imaging techniques can provide supplementary information used to improve staging and therapy planning. Imaging aimed to find minimally invasive therapy to make better results and reduce side effects. Probably, the most important factor in reducing mortality of certain cancers is an early diagnosis of cancer via screening based on imaging. The most common cancer in women is breast cancer. It is considered as the second major cause of cancer deaths in females, and therefore it remained as an important medical and socio-economic issue. Medical imaging has always formed part of breast cancer care and has used in all phases of cancer management from detection and staging to therapy monitoring and post-therapeutic follow-up. An essential action to be performed in the preoperative staging of breast cancer based on breast imaging. The general term of breast imaging refers to breast sonography, mammography, and magnetic resonance tomography (MRT) of the breast (magnetic resonance mammography, MRM). Further development in technology will lead to increase imaging speed to meet physiological processes requirements. One of the issues in the diagnosis of breast cancer is sensitivity limitation. To overcome this limitation, complementary imaging examinations are utilised that traditionally includes screening ultrasound, and combined mammography and ultrasound. Development in targeted imaging and therapeutic agents calls for close cooperation among academic environment and industries such as biotechnological, IT and pharmaceutical industries.
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Affiliation(s)
- Zeinab Safarpour Lima
- Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mohammad Reza Ebadi
- Shohadaye Haft-e-tir Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Ghazaleh Amjad
- Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Ladan Younesi
- Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
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3
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Abstract
The assessment of extent and severity of IBD is crucial for directing treatment decisions. Clinical symptoms alone are neither sensitive nor specific for the assessment of lesion severity in IBD. Cross-sectional imaging techniques, as well as small-bowel capsule endoscopy (SBCE) and device-assisted enteroscopy, have a high accuracy for assessing the extent of mucosal lesions, and are reliable alternatives to ileocolonoscopy. New endoscopic techniques and devices are emerging for improved follow-up and surveillance. In this Review, we discuss different imaging techniques that are used to assess IBD activity and to survey patients with IBD, and highlight the latest developments in each area. Moreover, technical improvements and new tools that aim to measure intestinal fibrosis, postoperative recurrence, activity indices and endoscopic features are analysed. All of these imaging techniques are aimed at changing the paradigm from symptom-driven to lesion-driven treatment of IBD.
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Ma Q, Chen B, Gao S, Ji T, Wen Q, Song Y, Zhu L, Xu Z, Liu L. 99mTc-3P4-RGD2 scintimammography in the assessment of breast lesions: comparative study with 99mTc-MIBI. PLoS One 2014; 9:e108349. [PMID: 25250628 PMCID: PMC4176966 DOI: 10.1371/journal.pone.0108349] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 08/19/2014] [Indexed: 12/03/2022] Open
Abstract
Purpose To compare the potential application of 99mTc-3P-Arg-Gly-Asp (99mTc-3P4-RGD2) scintimammography (SMM) and 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) SMM for the differentiation of malignant from benign breast lesions. Method Thirty-six patients with breast masses on physical examination and/or suspicious mammography results that required fine needle aspiration cytology biopsy (FNAB) were included in the study. 99mTc-3P4-RGD2 and 99mTc-MIBI SMM were performed with single photon emission computed tomography (SPECT) at 60 min and 20 min respectively after intravenous injection of 738±86 MBq radiotracers on a separate day. Images were evaluated by the tumor to non-tumor localization ratios (T/NT). Receiver operating characteristic (ROC) curve analysis was performed on each radiotracer to calculate the cut-off values of quantitative indices and to compare the diagnostic performance for the ability to differentiate malignant from benign diseases. Results The mean T/NT ratio of 99mTc-3P4-RGD2 in malignant lesions was significantly higher than that in benign lesions (3.54±1.51 vs. 1.83±0.98, p<0.001). The sensitivity, specificity, and accuracy of 99mTc-3P4-RGD2 SMM were 89.3%, 90.9% and 89.7%, respectively, with a T/NT cut-off value of 2.40. The mean T/NT ratio of 99mTc-MIBI in malignant lesions was also significantly higher than that in benign lesions (2.86±0.99 vs. 1.51±0.61, p<0.001). The sensitivity, specificity and accuracy of 99mTc-MIBI SMM were 87.5%, 72.7% and 82.1%, respectively, with a T/NT cut-off value of 1.45. According to the ROC analysis, the area under the curve for 99mTc-3P4-RGD2 SMM (area = 0.851) was higher than that for 99mTc-MIBI SMM (area = 0.781), but the statistical difference was not significant. Conclusion 99mTc-3P4-RGD2 SMM does not provide any significant advantage over the established 99mTc-MIBI SMM for the detection of primary breast cancer. The T/NT ratio of 99mTc-3P4-RGD2 SMM was significantly higher than that of 99mTc-MIBI SMM. Both tracers could offer an alternative method for elucidating non-diagnostic mammograms.
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Affiliation(s)
- Qingjie Ma
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Bin Chen
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Shi Gao
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Tiefeng Ji
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Qiang Wen
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Yan Song
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Lei Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Zheli Xu
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Lin Liu
- China-Japan Union Hospital, Jilin University, Changchun, China
- * E-mail:
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Ahmadinejad N, Movahedinia S, Movahedinia S, Shahriari M. Association of mammographic density with pathologic findings. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:e16698. [PMID: 24693404 PMCID: PMC3955519 DOI: 10.5812/ircmj.16698] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/25/2013] [Accepted: 08/27/2013] [Indexed: 01/10/2023]
Abstract
Background Breast cancer is one of the most common cancers in the world and is the first cause of death due to cancer among women. Mammography is the best screening method and mammographic density, which determines the percentage of fibro glandular tissue of breast, is one of the strongest risk factors of breast cancer. Because benign and malignant lesions may present as dense lesions in mammography so it is necessary to take a core biopsy of any suspicious lesions to evaluate pathologic findings. Objectives The aim of this study was to assess the association between mammographic density and histopathological findings in Iranian population. Moreover, we assessed the correlation between mammographic density and protein expression profile. We indeed, determined the accuracy and positive predictive value and negative predictive value of mammographic reports in our center. Patients and Method This study is a cross-sectional study carried out among 131 eligible women who had referred to imaging center for mammographic examination and had been advised to take biopsy of breast tissue. All participants of the study had filled out the informed consent. Pathologic review was performed blinded to the density status. Patients were divided into low density breast tissue group (ACR density group 1-2) and high density breast tissue group (ACR 3, 4) and data was compared between these two groups. Statistical analysis performed using SPSS for windows, version 11.5. We used chi-square, t-test, and logistic regression test for analysis and Odds Ratio calculated where indicated. Results In patients with high breast densities, malignant cases (61.2%) were significantly more in comparison to patients with low breast densities (37.3%) (P= 0.007, OR=2.66 95% CI=1.29-5.49). After adjusting for age, density was associated with malignancy in age groups <46 years (P=0.007), and 46-60 years (P=0.024) but not in age group >60yrs (P=0.559). Adjusting for menopausal status, density showed association with malignancy in both pre-menopause (P=0.041) and menopause (P=0.010) patients. Using logistic regression test, only age and density showed independent association with risk of breast cancer. No association was found between density and protein profile expression. Mammographic method has a false negative percent of 10.3% for negative BI-RADS group and a Positive Predictive Value (PPV) of 69.6% for positive BI-RADS group. PPVs for BI-RADS 4a, 4b, 4c and 5 were 16%, 87.5%, 84.6%, and 91.5% respectively. NPVs for BI-RADS 1, 2 and 3 were 66.7%, 95.8% and 90.0% respectively. Conclusions In this study we found that increasing in mammographic density is associated with an increase in malignant pathology reports. Expression of ER, PR and HER-2 receptors didn't show association with density. Our mammographic reports had a sensitivity of 94.1% and a specificity of 55.6%, which shows that our mammography is an acceptable method for screening breast cancer in this center.
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Affiliation(s)
- Nasrin Ahmadinejad
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences (TUMS), Tehran, IR Iran
| | - Samaneh Movahedinia
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, IR Iran
| | - Sajjadeh Movahedinia
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, IR Iran
- Corresponding Author: Sajjadeh Movahedinia, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences (TUMS), Imam Khomeini Hospital, Tehran, Iran. Tel: +98-2166581577, E-mail:
| | - Mona Shahriari
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, IR Iran
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Al-Saeedi FJ, Mathew PM, Luqmani YA. Assessment of tracer 99mTc(V)-DMSA uptake as a measure of tumor cell proliferation in vitro. PLoS One 2013; 8:e54361. [PMID: 23335999 PMCID: PMC3545874 DOI: 10.1371/journal.pone.0054361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 12/11/2012] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To examine whether (99m)Tc(V)-DMSA could be used as a non-invasive measure of cancer cell proliferation. METHODS Human breast cancer MCF-7, MDA-MB-231 and pII, and prostate cancer PC-3 cell lines were grown to 30, 50 and 100% confluency and pulsed with (99m)Tc(V)-DMSA in media for 60 min at 37°C. DNA synthesis was analysed by quantification of the S phase using flow cytometry, [methyl-(3)H]thymidine incorporation and expression of proliferation markers PCNA and Ki-67 using realtime PCR. One way ANOVA was used to compare groups. RESULTS In all cell lines rates of (99m)Tc(V)-DMSA uptake were inversely related to cell density. This was paralleled by similar trends in S phase proportions, [methyl-(3)H]thymidine incorporation and expression of PCNA and Ki-67. CONCLUSION Rates of (99m)Tc(V)-DMSA uptake into different types of tumour cells correlate well with cell density that is useful as a non-invasive measure of tumour cellular proliferation in vivo.
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Affiliation(s)
- Fatma J Al-Saeedi
- Nuclear Medicine Department, Faculty of Medicine, Health Sciences Center, Kuwait University, Hawally, Jabriya, Kuwait.
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7
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Staník R, Světlík J, Benkovský I. DMSA and its complexes with radioisotopes: review. J Radioanal Nucl Chem 2012. [DOI: 10.1007/s10967-012-1743-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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8
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Papantoniou V, Valsamaki P, Sotiropoulou E, Tsaroucha A, Tsiouris S, Sotiropoulou M, Marinopoulos S, Kounadi E, Karianos T, Fothiadaki A, Archontaki A, Syrgiannis K, Ptohis N, Makris N, Limouris G, Antsaklis A. Increased breast density correlates with the proliferation-seeking radiotracer (99m)Tc(V)-DMSA uptake in florid epithelial hyperplasia and in mixed ductal carcinoma in situ with invasive ductal carcinoma but not in pure invasive ductal carcinoma or in mild epithelial hyperplasia. Mol Imaging 2011; 10:370-6. [PMID: 21521552 DOI: 10.2310/7290.2010.00056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 07/22/2010] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to assess the relationship of mammographic breast density (BD) and cell proliferation/focal adhesion kinase activation-seeking radiotracer technetium 99m pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) uptake in women with different breast histologies, that is, mild epithelial hyperplasia (MEH), florid epithelial hyperplasia (FEH), mixed ductal carcinoma in situ with invasive ductal carcinoma (DCIS + IDC), and pure IDC. Fifty-five women with histologically confirmed mammary pathologies were submitted preoperatively to mammography and 99mTc(V)-DMSA scintimammography. The percentage and intensity of 99mTc(V)-DMSA uptake and the percentage of BD were calculated by computer-assisted methods and compared (t-test) between the breast pathologies. In breasts with increased BD, FEH and DCIS + IDC were found. On the contrary, pure IDC and MEH were identified in breasts with significantly lower BD values. In breasts with increased 99mTc(V)-DMSA area and intensity of uptake, FEH was the main lesion found compared to all other histologies. Linear regression analysis between BD and 99mTc(V)-DMSA uptake area and intensity revealed significant coefficients of correlation (r = .689, p < .001 and r = .582, p < .001, respectively). Increased BD correlates with the presence of FEH and mixed DCIS + IDC but not with pure IDC or MEH. Its close relationship to 99mTc(V)-DMSA, which also showed an affinity to FEH, indicates that stromal microenvironment may constitute a specific substrate leading to progression to different subtypes of cancerous lesions originating from different pathways.
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Papantoniou V, Tsaroucha A, Valsamaki P, Tsiouris S, Sotiropoulou E, Karianos T, Marinopoulos S, Fothiadaki A, Sotiropoulou M, Archontaki A, Syrgiannis K, Dimitrakakis K, Antsaklis A. Ibuprofen Induces Reduction of the Proliferation-Seeking Radiotracer
99m
Tc-(V)DMSA Uptake in Severe Epithelial Breast Hyperplasia without Atypia. Mol Imaging 2010. [DOI: 10.2310/7290.2010.00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Vassilios Papantoniou
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Angeliki Tsaroucha
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Pipitsa Valsamaki
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Spyridon Tsiouris
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Evangelia Sotiropoulou
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Theodore Karianos
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Spyridon Marinopoulos
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Athina Fothiadaki
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Maria Sotiropoulou
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Aikaterini Archontaki
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Konstantinos Syrgiannis
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Konstantinos Dimitrakakis
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
| | - Aris Antsaklis
- From the Nuclear Medicine, Radiology, and Pathology Departments and Gynaecology and Obstetrics Clinic, “Alexandra” University Hospital, Athens, Greece, and Radiology Department, “Sotiria” General Hospital, Athens, Greece
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Papantoniou VJ, Sotiropoulou EK, Valsamaki PN, Tsaroucha AG, Sotiropoulou MG, Ptohis ND, Stipsanelli AJ, Dimitrakakis KE, Marinopoulos SG, Tsiouris ST, Antsaklis AJ. Reduced uptake of the proliferation-seeking radiotracer technetium-99m-labelled pentavalent dimercaptosuccinic acid in a 47-year-old woman with severe breast epithelial hyperplasia taking ibuprofen: a case report. J Med Case Rep 2010; 4:89. [PMID: 20236511 PMCID: PMC2850350 DOI: 10.1186/1752-1947-4-89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 03/17/2010] [Indexed: 11/19/2022] Open
Abstract
Introduction Recent studies have reported a risk reduction in the progression of benign breast disease to breast carcinoma through COX-2 pathways. Case presentation We present a case of severe epithelial hyperplasia in a 47-year-old woman with increased breast density submitted to scintimammography by the proliferation-imaging tracer Technetium-99m-labelled pentavalent dimercaptosuccinic acid, before and after an oral ibuprofen treatment for 4 weeks. The radiotracer uptake after ibuprofen intake was significantly reduced, both visually and by semi-quantitative analysis, based on a calculation of lesion-to-background ratios. Conclusion In proliferating breast lesions, scintigraphically displayed reduction in Technetium-99m-labelled pentavalent dimercaptosuccinic acid uptake may indicate inhibition by ibuprofen in the pathway of malignant epithelial cell transformation.
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Affiliation(s)
- Vassilios J Papantoniou
- Department of Nuclear Medicine, Alexandra University Hospital, Vasilissis Sofias Avenue, Athens, 11528, Greece.
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Breast density, scintimammographic 99mTc(V)DMSA uptake, and calcitonin gene related peptide (CGRP) expression in mixed invasive ductal associated with extensive in situ ductal carcinoma (IDC + DCIS) and pure invasive ductal carcinoma (IDC): correlation with estrogen receptor (ER) status, proliferation index Ki-67, and histological grade. Breast Cancer 2010; 18:286-91. [DOI: 10.1007/s12282-009-0192-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 11/30/2009] [Indexed: 10/19/2022]
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Al-Saeedi F. Role of 99mTc-(V)DMSA in Detecting Tumor Cell Proliferation. ANALYTICAL CHEMISTRY INSIGHTS 2007. [DOI: 10.4137/117739010700200001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pentavalent technetium-99m dimercaptosuccinic acid (99mTc-(V)DMSA) is a tumor-seeking agent which was introduced to evaluate, image, and manage many types of cancers. In this review, the beginning of, and the most recent applications of using this agent was appraised. The relation with tumor cell detection and proliferation was reported and several mechanisms of uptake of 99mTc-(V)DMSA in tumor cells are described.
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Affiliation(s)
- Fatma Al-Saeedi
- Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait
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Al-Saeedi F. Role of 99mTc-(V)DMSA in detecting tumor cell proliferation. ANALYTICAL CHEMISTRY INSIGHTS 2007; 2:81-3. [PMID: 19662181 PMCID: PMC2716817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Pentavalent technetium-99m dimercaptosuccinic acid ((99m)Tc-(V)DMSA) is a tumor-seeking agent which was introduced to evaluate, image, and manage many types of cancers. In this review, the beginning of, and the most recent applications of using this agent was appraised. The relation with tumor cell detection and proliferation was reported and several mechanisms of uptake of (99m)Tc-(V)DMSA in tumor cells are described.
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Affiliation(s)
- Fatma Al-Saeedi
- Correspondence: Dr. Fatma Al-Saeedi, Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, P.O. Box: 24923, postal code/zip 13110, Safat, Kuwait. Tel: 00965-4986245; Fax: 00965-5338936;
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Brem RF, Fishman M, Rapelyea JA. Detection of ductal carcinoma in situ with mammography, breast specific gamma imaging, and magnetic resonance imaging: a comparative study. Acad Radiol 2007; 14:945-50. [PMID: 17659240 DOI: 10.1016/j.acra.2007.04.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2007] [Revised: 04/09/2007] [Accepted: 04/08/2007] [Indexed: 12/11/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the sensitivity of high-resolution breast-specific gamma imaging (BSGI) for the detection of ductal carcinoma in situ (DCIS) based on histopathology and to compare the sensitivity of BSGI with mammography and magnetic resonance imaging (MRI) for the detection of DCIS. MATERIALS AND METHODS Twenty women, mean 55 years (range 34-76 years), with 22 biopsy-proven DCIS were retrospectively reviewed. After injection of 25-30 mCi (925-1,110 MBq) technetium 99m-sestamibi, patients had BSGI with a high-resolution, small-field-of-view gamma camera in craniocaudal and mediolateral oblique projections. BSGI studies were prospectively classified according to focal radiotracer uptake using a 1 to 5 scale, as normal 1), with no focal or diffuse uptake; benign 2), with minimal patchy uptake; probably benign 3), with scattered patchy uptake; probably abnormal 4), with mild focal radiotracer uptake; and abnormal 5), with marked focal radiotracer uptake. Imaging findings were compared to findings at biopsy or surgical excision. The sensitivity of BSGI, mammography, and when performed, MRI were determined for the detection of DCIS. Breast MRI was performed on seven patients with eight biopsy-proven foci. The sensitivities were compared using a two-tailed t-test and confidence intervals were determined. RESULTS Pathologic tumor size of the DCIS ranged from 2 to 21 mm (mean 9.9 mm). Of 22 cases of biopsy-proven DCIS in 20 women, 91% were detected with BSGI, 82% were detected with mammography, and 88% were detected with magnetic resonance imaging. BSGI had the highest sensitivity for the detection of DCIS, although this small sample size did not demonstrate a statistically significant difference. Two cases of DCIS (9%) were diagnosed only after BSGI demonstrated an occult focus of radiotracer uptake in the contralateral breast, previously undetected by mammography. There were two false-negative BSGI studies CONCLUSIONS BSGI has higher sensitivity for the detection of DCIS than mammography or MRI and can reliably detect small, subcentimeter lesions.
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Affiliation(s)
- Rachel F Brem
- Breast Imaging and Intervention, The George Washington University, Washington, DC 20037, USA.
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Tsiouris S, Pirmettis I, Chatzipanagiotou T, Ptohis N, Papantoniou V. Pentavalent technetium-99m dimercaptosuccinic acid [99m Tc-(V)DMSA] brain scintitomography--a plausible non-invasive depicter of glioblastoma proliferation and therapy response. J Neurooncol 2007; 85:291-5. [PMID: 17554495 DOI: 10.1007/s11060-007-9410-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Accepted: 05/03/2007] [Indexed: 01/09/2023]
Abstract
The biological behavior and prognosis of gliomas depend largely on cellular proliferation, resistance to chemotherapy, and metastatic potential. Proliferative propensity has significant implications on patient management but its assessment requires tissue sampling; the non-invasive estimation of brain tumor proliferation represents therefore a major goal. Pentavalent technetium-99 m dimercapto-succinic acid [99m Tc-(V)DMSA] is a tumor-seeking radiotracer displaying affinity for gliomas; its intracellular accumulation is directly linked to cell proliferation. We performed a tomographic 99m Tc-(V)DMSA brain scan in a 35-year-old male baring a recurrent glioblastoma multiforme, to depict its proliferative disposition. The patient had been diagnosed 14 months earlier and had been submitted to surgery, followed by adjuvant radiotherapy and temozolomide-based chemotherapy. On clinical suspicion of recurrence 5 months later, magnetic resonance imaging (MRI) revealed a lesion at the site of preceded surgery, which was treated by imatinib mesylate. No improvement was ascertained the following months and radiographic assessment verified tumor progression. Scintitomography revealed avid radiotracer uptake in the entirety of the lesion (the distribution of radioactivity closely conforming to the morphological tumor boundaries), an indication that the neoplasm demonstrated no substantial proliferation decline in response to imatinib. The patient deceased a few weeks later. Mounting in vivo and in vitro evidence indicates that 99m Tc-(V)DMSA is a credible non-invasive proliferation depicter, its cellular accumulation linked closely to phosphate uptake and kinase pathway activation. A potential role in patient management, prognosis estimation, and therapy response monitoring could occur for this tracer.
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Affiliation(s)
- Spyridon Tsiouris
- Nuclear Medicine Department, Alexandra University Hospital, 80, Vas. Sophia's Avenue & 2, K. Lourou Street, Athens 115 28, Greece.
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Gommans GMM, van der Zant FM, van Dongen A, Boer RO, Teule GJJ, de Waard JWD. 99MTechnetium-sestamibi scintimammography in non-palpable breast lesions found on screening X-ray mammography. Eur J Surg Oncol 2007; 33:23-7. [PMID: 17126524 DOI: 10.1016/j.ejso.2006.10.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Accepted: 10/16/2006] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The sensitivity and specificity of (99m)Tc-sestamibi scintimammography in patients with non-palpable breast lesions diagnosed by screening mammography and the value of (99m)Tc-sestamibi to detect axillary lymph node metastases was determined. METHODS Between September 2000 and December 2003, 103 females with non-palpable breast lesions were included for further evaluation. X-ray mammography was repeated and 99mTc-sestamibi scintimammography performed within one-week. Anterior, and left and right lateral images were obtained. The scintimammography was analysed by 2 experienced observers who were blinded to the clinical, pathological, and radiological results. The sensitivity and specificity of scintimammography to diagnose non-palpable lesion(s), including the axillary regions, was compared with histopathology, clinical, and radiological follow up. RESULTS Two patients (one non-small lung cancer and one non-Hodgkin's disease) were excluded. Both showed (99m)Tc-sestamibi avid lesions in the breast and axillary region. In the remaining 101 patients, 37 true positive (TP), 4 false positive (FP), 52 true negative (TN), and 8 false negative (FN) breast carcinomas were found. The specificity was 92.8%, sensitivity 82.2%, positive predictive value (PPV) 90.2%, and negative predictive value (NPV) 86.6%. (99m)Tc-sestamibi scintimammography showed axillary lesions in 5/15 (33%) patients with axillary lymph node metastasis. CONCLUSION In patients with non-palpable lesions diagnosed by screening- X-ray-mammography, (99m)Tc-sestamibi scintimammography provided high specificity and PPV. Furthermore, (99m)Tc-sestamibi scintimammography detected 33% of patients with axillary lymph node metastases. Therefore, (99m)Tc-sestamibi scintimammography could be of incremental value in the surgical work-up of these patients.
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Affiliation(s)
- G M M Gommans
- Department of Nuclear Medicine, Westfries Hospital Hoorn, PO BOX 600, 1620 AR Hoorn, The Netherlands.
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Papantoniou V, Tsiouris S, Koutsikos J, Sotiropoulou M, Mainta E, Lazaris D, Valsamaki P, Melissinou M, Zerva C, Antsaklis A. Scintimammographic detection of usual ductal breast hyperplasia with increased proliferation rate at risk for malignancy. Nucl Med Commun 2006; 27:911-7. [PMID: 17021432 DOI: 10.1097/01.mnm.0000243367.73141.85] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To estimate whether breast uptake of (99m)Tc-(V)DMSA and (99m)Tc-sestamibi in usual ductal epithelial breast hyperplasia (UDH) and apocrine metaplasia is related to cell proliferation rate (Ki-67) and oestrogen receptor (ER) expression, both of which are associated with the potential risk of evolving to malignancy. METHODS Among patients referred for suspicious breast findings on palpation and/or mammography and evaluated preoperatively with both radiopharmaceuticals, we retrospectively studied 17 (10 with UDH: group I; and seven with apocrine metaplasia: group II). Lesion-to-background (L/B) ratios in early and late acquisitions were calculated for both radiotracers in both groups, as well as their retention ratios. Ki-67 and oestrogen receptor expression were determined immunohistochemically. The late L/B ratios between the two tracers were compared, as were the late ratios for each tracer between Ki-67 < or = 3% and > 3%, and between ER < or = 15% and > 15%. Linear regression analysis was also performed between L/B and retention ratios and Ki-67 expression. RESULTS There was a significant increase of the (99m)Tc-(V)DMSA L/B ratio in late images as compared to the early images in group I (P<0.05), while in group II it was not significantly increased (P=0.084). (99m)Tc-sestamibi ratios did not demonstrate variability over time in either group (P=0.156 and 0.274, respectively). Significant coefficient correlation was found between the (99m)Tc-(V)DMSA L/B(late) ratios and retention ratios and Ki-67 levels only for group I (r=0.889, P<0.001 and r=0.802, P<0.01, respectively). The (99m)Tc-(V)DMSA L/B(late) ratios in group I were significantly higher when Ki-67 > 3% than when Ki-67 < or = 3% (P=0.016) but did not differ considerably between ER > 15% and < or = 15% (P=0.732). CONCLUSION (99m)Tc-(V)DMSA uptake in UDH correlates with Ki-67 expression. This could prove useful in identifying women with benign but high-risk breast pathologies who might benefit from chemoprophylaxis.
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Papantoniou V, Tsiouris S, Koutsikos J, Zerva C. Imaging focal adhesion kinase activation in breast cancer-promoting cell proliferation and carcinogenesis, but not migration, invasion, or metastatic predilection. Hum Pathol 2006; 37:1241-2; author repy 1242. [PMID: 16938535 DOI: 10.1016/j.humpath.2006.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Accepted: 04/10/2006] [Indexed: 11/19/2022]
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Papantoniou V, Tsiouris S. In vitro verification of the correlation of in vivo 99mTc-(V)DMSA uptake with cellular proliferation rate. Eur J Nucl Med Mol Imaging 2005; 32:1240-1. [PMID: 16025274 DOI: 10.1007/s00259-005-1860-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Papantoniou V, Koutsikos J, Sotiropoulou M, Feida E, Tsiouris S. Recurrent bilateral mammary fibromatosis (desmoid tumor) imaged with technetium-99m pentavalent dimercaptosuccinic acid [99mTc-(V)DMSA] scintimammography. Gynecol Oncol 2005; 97:964-9. [PMID: 15896828 DOI: 10.1016/j.ygyno.2005.03.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2004] [Revised: 02/03/2005] [Accepted: 03/13/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Breast fibromatosis is a rare, benign, recurring, locally destructive entity. CASE A 35-year-old woman underwent right-sided lumpectomy, revealing fibromatosis with epithelial hyperplasia. Two years later, she was re-evaluated due to a three times as large mass recurrence on X-ray mammography. (99m)Tc-(V)DMSA scintimammography revealed diffuse increased radiotracer uptake occupying the entire breast. A less widespread similar uptake was observed in the contralateral breast. Mammography did identify neither the posterior margins of the mass nor the left-sided lesion. The patient underwent mastectomy and left-sided open biopsy, revealing bilateral fibromatosis. Ki-67 expression was moderate. CONCLUSIONS (99m)Tc-(V)DMSA scintimammography can provide information regarding the nature of the lesion, its extent and bilateral involvement (especially in dense breasts) and could prove useful as a predictor of its potential for recurrence.
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Affiliation(s)
- Vassilios Papantoniou
- Department of Nuclear Medicine, ALEXANDRA University Hospital, 80, Vas. Sophia's Ave. and 2, K. Lourou Str., 115 28 Athens, Greece.
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