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Diagnostic Value of 99mTc-Methylene Diphosphonate and 99mTc-Pentavalent DMSA Compared with 99mTc-Sestamibi for Palpable Breast Lesions

Teresa Massardo, MD1, Omar Alonso, MD2, Levent Kabasakal, MD3, Augusto Llamas-Olier, MD4, Uma Ravi Shankar, MD5, Huiqing Zhu, MD6, Lucía Delgado, MD7, Patricio González, MD1, Fernando Mut, MD2 and Ajit K. Padhy, MD8

1 Nuclear Medicine Centre, University of Chile, Santiago, Chile
2 Nuclear Medicine Centre, University of Uruguay, Montevideo, Uruguay
3 Nuclear Medicine Department, Istanbul University, Istanbul, Turkey
4 Nuclear Medicine Department, National Cancer Institute, Bogota, Colombia
5 Nuclear Medicine Department, Indraprastha Apollo Hospitals, New Delhi, India
6 Nuclear Medicine Department, Hua Shan Hospital, Shanghai Medical University, Shanghai, China
7 Medical Oncology Department, University of Uruguay, Montevideo, Uruguay
8 Nuclear Medicine Section, Department of Human Health, International Atomic Energy Agency, Vienna, Austria



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  		FIGURE 1. A 51-y-old woman with approximately 19-mm palpable lesion of left breast. Craniocaudal mammogram showed probable malignancy (A, arrow). Scintimammograms are displayed in lateral views. Early sestamibi scan at 10 min (B) and delayed sestamibi scan at 1 h (C) showed clear, focal lesion in left breast (true-positive finding). Early MDP scan at 10 min (D) also showed focal uptake in left breast, reported as positive finding and diffuse activity. Early DMSA-V scan at 10 min (E) and delayed DMSA-V scan at 2 h (F) showed focal and diffuse uptake in left breast, reported as positive finding for early scan. Compared with other 2 radiopharmaceuticals, sestamibi showed net focal uptake and almost no contralateral activity. Histopathology showed ductal infiltrating carcinoma in left breast, with 11 of 19 lymph nodes in left axilla positive for cancer. HORA = hour.

 




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