Nuclear Medicine and Molecular Imaging

The Korean Society of Nuclear Medicine (대한핵의학회)
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The value of Dedicated Tc-99m MIBI Scintimammography in the Evaluation of Patients with Palpable Breast Lesions in Comparison with Mammography: Preliminary Result

만져지는 유방 병소를 평가하는데 있어 Tc-99m MIBI 유방스캔과 유방촬영 술의 비교: 예비 결과

  • Cho, Arthur (Division of Nuclear Medicine, Department of Radiology, Yonsei University Health System) ;
  • Cho, Ho-Jin (Division of Nuclear Medicine, Department of Radiology, Yonsei University Health System) ;
  • Yun, Mi-Jin (Division of Nuclear Medicine, Department of Radiology, Yonsei University Health System) ;
  • Park, Byeong-Woo (Department of Surgery, Yonsei University Health System) ;
  • Kim, Min-Jung (Department of Radiology, Yonsei University Health System) ;
  • Kim, Eun-Kyung (Department of Radiology, Yonsei University Health System) ;
  • Kang, Won-Jun (Division of Nuclear Medicine, Department of Radiology, Yonsei University Health System) ;
  • Lee, Jong-Doo (Division of Nuclear Medicine, Department of Radiology, Yonsei University Health System)
  • 조응혁 (연세대학교 의과대학 세브란스병원 영상의학과교실 핵의학과) ;
  • 조호진 (연세대학교 의과대학 세브란스병원 영상의학과교실 핵의학과) ;
  • 윤미진 (연세대학교 의과대학 세브란스병원 영상의학과교실 핵의학과) ;
  • 박병우 (연세대학교 의과대학 세브란스병원 영상의학과교실 외과) ;
  • 김민정 (연세대학교 의과대학 세브란스병원 영상의학과교실 영상의학과) ;
  • 김은경 (연세대학교 의과대학 세브란스병원 영상의학과교실 영상의학과) ;
  • 강원준 (연세대학교 의과대학 세브란스병원 영상의학과교실 핵의학과) ;
  • 이종두 (연세대학교 의과대학 세브란스병원 영상의학과교실 핵의학과)
  • Published : 2009.02.28
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Abstract

Purpose: There are few studies evaluating the usefulness of dedicated high-resolution scintimammography and no studies using delayed washout with this dedicated high resolution scintimammography for the evaluation of breast lesions. We underwent this study to evaluate the clinical usefulness of Tc-99m MIBI in evaluating patients with palpable breast lesions using dedicated high-resolution scintimammography. Materials and Methods: This study included 19 patients with 23 palpable breast lesions who underwent mammography. Tc-99m MIBI was taken to further characterize these lesions. Scintimammography images were acquired with standard craniocaudal and mediolateral oblique views and delayed images were additionally taken. Final conclusions were based on histopathology, either by biopsy or mastectomy results. Results: Eighteen lesions were malignant and five were benign. Mammography was indeterminate for thirteen lesions, nine of those were malignant. Mammography also categorized one lesion as benign in a dense breast, but scintimammography and pathology results showed malignancy. Of the five benign lesions, two were visible on scintimammography, but delayed images showed washout. Conclusion: Based on our preliminary results, dedicated high resolution scintimammography seems to be very useful in characterizing palpable lesions that were indeterminate or negative on mammography.

목적: 기존의 Tc-99m MIBI 유방스캔은 유방암 진단에 어느 정도 유용하다고 알려져 있으나 작은 병변을 발견하는데 민감도가 낮은 것이 문제점이었다. 고해상도 유방 전용 스캔 또한 작은 병변에 대한 예민도에 한계가 있다. 본 연구에서는 1 cm이상의 촉지되는 병변에 대해서 고해상도 유방 전용 스캔의 유용성을 알아보고자 하였다. 대상 및 방법: 19명의 만져지는 병변이 있은 환자를 대상으로 Tc-99m MIBI 유방스캔을 시행하였다 약 925-1110 MBq을 투여한 10분 후에 조기 영상을 촬영하고, 30분 후에 지연 영상을 시행하였다. 결과: 19명중 23개의 병변이 조직학적으로 진단되었고, 그 중 18개는 악성으로, 5개 병변은 양성으로 진단되었다. 고해상 유방스캔이 악성 병변을 찾는데 있어 민감도 100%로 매우 유용하였다. 다섯 개의 양성 중 2개는 초기 영상에서 섭취 증가를 보였으나 지연 영상에서 섭취감소를 보여 양성으로 판단하였고 병변 진단에 지연 영상이 도움이 되었다. 유방 촬영술이 13개의 병변들에서 모호한 결과를 보였고 1개의 악성 병변을 양성으로 진단한 것에 비해 유방 전용 스캔은 악성 선별에 훨씬 우수한 결과를 보였다. 결론: 본 연구에 의하면 고해상 유방 전용 스캔은 1 cm 이상의 만져지는 병변에서 악성 병변을 선별하는데 큰 도움이 될 것으로 기대된다. 이러한 결과는 좀 더 많은 환자를 대상으로 한 연구에 의해 검증되어야 하며 특히 지연영상을 촬영하는 최적의 시간에 대해서도 비교 연구가 필요할 것으로 사료된다.

Keywords

References

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