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Scintimammography with 99mTc-Sestambibi Compared to Mammography and Magnetic Resonance Imaging for Breast Cancer

التصوير الومضاني لسرطان الثدي بالـ 99mTc-Sestamibi و مقارنته مع التصوير الشعاعي و الرنين المغناطيسي

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 Publication date 2013
and research's language is العربية
 Created by Shamra Editor




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112 patients with suspected breast lesions were investigated using Scintimammography with 99mTc-MIBI, mammography and magnetic resonance to compare the diagnostic accuracy of Scintimammography with that of mammography and magnetic resonance in the detecting of primary breast cancer. Excisional biopsy was taken after 7-10 days of Scintimammography. 70 patients were diagnosed with breast cancer; 55 palpable and 15 non-palpable lesions, while 42, 30 palpable and 12 non-palpable were diagnosed as benign lesions. The sensitivity of the three methods were high and approximate (89% by Scintimammography, 90% by mammography and 94% by magnetic resonance), while Scintimammography showed higher specificity (86%) versus 21% for mammography and 50% for magnetic resonance. The high specificity in addition to high positive (91%) and negative (82%) predictive values of Scintimammography resulted in a highly accurate diagnostic (87%) method compared to mammography (64%) and magnetic resonance (78%) procedures. Through the complementary use of Scintimammography it is possible to increase the sensitivity for the detection of breast cancer. In patients in whom the status of a palpable breast mass remains unclear, Scintimammography may help to reduce the amount of unnecessary biopsies.


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Research summary
تتناول هذه الدراسة مقارنة بين ثلاثة أنواع من الفحوصات التشخيصية للكشف عن سرطان الثدي: التصوير الومضاني باستخدام الميبي المشع (99mTc-MIBI)، التصوير الشعاعي (Mammography)، والتصوير بالرنين المغناطيسي (MRI). شملت الدراسة 112 مريضة تم تشخيص 70 منهن بسرطان الثدي و42 بحالات سليمة. أظهرت النتائج أن حساسية الفحوصات الثلاثة كانت عالية ومتقاربة (89% للتصوير الومضاني، 90% للتصوير الشعاعي، و94% للرنين المغناطيسي)، بينما تميز التصوير الومضاني بنوعية أعلى (86%) مقارنة بالتخطيط الشعاعي (21%) والرنين المغناطيسي (50%). كما أظهر التصوير الومضاني دقة أعلى في التشخيص (87%) مقارنة بالتخطيط الشعاعي (64%) والرنين المغناطيسي (78%). تشير الدراسة إلى أن استخدام التصوير الومضاني كوسيلة متممة يمكن أن يزيد من حساسية الفحوصات الأخرى في اكتشاف سرطان الثدي، ويساهم في تقليل عدد الخزعات الاستئصالية غير المبررة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة مهمة في مجال تشخيص سرطان الثدي، حيث تقدم مقارنة شاملة بين ثلاثة أنواع من الفحوصات التشخيصية. ومع ذلك، يمكن توجيه بعض النقد البناء لهذه الدراسة. أولاً، كان من الممكن أن تكون الدراسة أكثر شمولية إذا تضمنت عددًا أكبر من المرضى، مما يزيد من قوة النتائج. ثانيًا، لم يتم التطرق بشكل كافٍ إلى تأثير العوامل الخارجية مثل العمر والتاريخ الطبي على دقة الفحوصات المختلفة. أخيرًا، كان من المفيد تضمين تحليل اقتصادي لتكلفة كل نوع من الفحوصات، مما يساعد في تحديد الخيار الأكثر فعالية من حيث التكلفة.
Questions related to the research
  1. ما هي الفحوصات الثلاثة التي تم مقارنتها في الدراسة؟

    تمت مقارنة التصوير الومضاني باستخدام الميبي المشع (99mTc-MIBI)، التصوير الشعاعي (Mammography)، والتصوير بالرنين المغناطيسي (MRI).

  2. ما هي نسبة حساسية التصوير الومضاني في الكشف عن سرطان الثدي؟

    كانت نسبة حساسية التصوير الومضاني 89%.

  3. ما هي الفائدة الرئيسية لاستخدام التصوير الومضاني كوسيلة متممة؟

    الفائدة الرئيسية هي زيادة حساسية الفحوصات الأخرى في اكتشاف سرطان الثدي وتقليل عدد الخزعات الاستئصالية غير المبررة.

  4. كيف تميز التصوير الومضاني مقارنة بالتخطيط الشعاعي والرنين المغناطيسي من حيث النوعية؟

    تميز التصوير الومضاني بنوعية أعلى (86%) مقارنة بالتخطيط الشعاعي (21%) والرنين المغناطيسي (50%).


References used
PARKIN, DM, PISANI, P, FERLAY, J, et al. Global Cancer Statistics. CA Cancer J Clin. Vol. 49, No. 1, 1999- pp. 33-64
POLLEI, SR, METTLER, FA, BARTOW, SA, et al. Occult Breast Cancer: prevalence and Radiographic Detectability. Radiology. Vol. 163, No. 2, 1987- pp. 459-462
BASSET, LW, LIU, TH, GIULIANO, AE, et al. The Prevalence of Carcinoma in Palpable Versus Impalpable, mammographically detected lesions. AJR. Vol. 157, No. 1, 1991- pp. 21-24
SICKLES, EA. Mammographic Features of Early Breast Cancer. AJR. Vol. 143, No. 3, 1984- pp. 461-464
MOSKOWITZ, M. The Predictive Value of Certain Mammographic Signs in Screening for Breast Cancer. Cancer. Vol. 51, No. 6, 1983- pp. 1007-1011
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