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Use of ^99mTc-Furifosmin Scintigraphy—Planar and SPECT—to Evaluate Suggestive Palpable and Nonpalpable Breast Lesions

Department of Obstetrics and Gynecology and Department of Nuclear Medicine, University Hospital, Vienna, Austria

Correspondence: For correspondence or reprints contact: Reinhard Obwegeser, MD, Division of Special Gynecology, Department of Obstetrics and Gynecology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.

ABSTRACT

Our objective was to evaluate the role of ^99mTc-furifosmin scintigraphy—planar and SPECT—in discriminating benign from malignant breast disease. Methods: The trial was prospective, open, and diagnostic. We recruited 30 consecutive patients with 14 palpable and 16 nonpalpable breast lesions. After receiving informed consent, we injected 555–640 MBq ^99mTc-furifosmin intravenously in the arm contralateral to the breast lesion. Planar imaging and SPECT were performed. All patients underwent excision of the tumor within 2 wk. Using histology as the gold standard, we calculated sensitivity, specificity, and positive and negative predictive values for ^99mTc-furifosmin in planar and SPECT technique. Results: For 18 malignant and 12 benign breast lesions, a sensitivity of 50% for planar imaging and 72% for SPECT was seen. Specificity and positive and negative predictive values were 83%, 82%, and 53%, respectively, for planar imaging and 50%, 68%, and 55%, respectively, for SPECT. For the 14 palpable tumors (10 malignant, 4 benign), which averaged 17 ± 10 mm in size (size range, 4–45 mm), a sensitivity of 60% for planar imaging and 80% for SPECT was achieved. Sixteen lesions were not palpable (median size, 9 ± 3 mm [size range, 4–13 mm]). In this subgroup, ^99mTc-furifosmin scintigraphy yielded a sensitivity of 37% for planar and 62% for SPECT technique (P > 0.05). Conclusion: ^99mTc-furifosmin scintigraphy is not a potent competitor to established scintigraphic procedures. In comparing this tracer with ^99mTc-sestamibi and ^99mTc-tetrofosmin, we cannot recommend ^99mTc-furifosmin for the diagnosis of breast cancer.

Key Words: ^99mTc-furifosmin • breast cancer • scintimammography