Single-photon emission computed tomography with ^99mtc-1-thio-dglucose for metabolic breast cancer imaging

Purpose. To evaluate the feasibility of using ^99mTc-thio-d-glucose SPECT in the detection of breast cancer. Materials and methods. A prospective study was conducted in 74 patients presenting with palpable masses or abnormal mammography/ultrasound scheduled for biopsy. All patients underwent SPECT with ^99mTc-TG. The mean age was 44 years (range 30-79 years) Results. Focal accumulation of radiopharmaceutical in breast were detected in 43 cases. The mean tumor-to-background ratio uptake was 1,87±0,82 and had a weak but significant positive correlation with Ki-67 and a negative correlation with mammography density. The sensitivity for cancer diagnosis was 55.55% and specificity 78.57%. SPECT showed axillary lesions in 6/26 (23%) patients with axillary lymph node metastasis. In the group of postmenopausal women, the sensitivity of the study was 72%, in postmenopausal patients with a tumor size of 2 cm or more, SPECT sensitivity with ^99mTc-TG increased to 77%. The low sensitivity in detecting a primary tumor was associated with bilateral diffuse uptake of radiopharmaceutical. Bilateral high-intensity inclusion of the drug was recorded in 27 patients with breast cancer. Bilateral accumulation of the drug is associated with a younger age (p = 0.011), active menstrual status (p = 0.006) and high mammographic density (p = 0.001). Conclusion. ^99mTc-TG SPECT can be used as an additional research method to assess the metabolism of lesion in postmenopausal patients with tumor sizes of more than 2 cm. In young premenopausal women with small tumor sizes, the method has low diagnostic efficiency and is not indicated for use.