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99mTc-Exametazime as a Breast Tumor-Seeking Agent: Comparison with 99mTc-Sestamibi

Brigitte Wilczek, MD1, Leif Svensson, PhD2, Rimma Danielsson, MD, PhD1, Fuat Celebiouglu, MD3, Stig A. Larsson, PhD4 and Hans Jacobsson, MD, PhD5

1 Department of Radiology, Karolinska University Hospital, Huddinge, Sweden
2 Department of Hospital Physics, Karolinska University Hospital, Huddinge, Sweden
3 Department of Surgery, Karolinska University Hospital, Huddinge, Sweden
4 Department of Hospital Physics, Karolinska University Hospital, Solna, Sweden
5 Department of Radiology, Karolinska University Hospital, Solna, Sweden



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  		FIGURE 1. 99mTc-exametazime mammoscintigraphy (500 MBq) of a 60-y-old woman in whom a 35-mm breast tumor was found at mammography. (A) Image showing tumor activity (arrow). (B) Same image showing ROIs used when evaluating patients of the comparative study (group II). Tumor ROI (yellow) is surrounded by 4-pixel-wide background ROI (red).

 


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  		FIGURE 2. Time-activity curves, after correction for physical decay, of 20 99mTc-exametazime examinations of breast cancer in different women. Curves show tumor uptake and uptake of a background region in ipsilateral breast. Examinations were normalized by area under curve.

 


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  		FIGURE 3. Box plot showing net tumor-to-background ratio of 21 breast cancers in 21 women examined with 99mTc-exametazime and 99mTc-sestamibi. Wilcoxon matched-pairs test showed no significant difference between the 2 tracers (P = 0.82). HMPAO = exametazime; MIBI = sestamibi.

 


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  		FIGURE 4. Box plot showing normalized uptake (cps/administered MBq) by 21 breast cancers in 21 women examined with 99mTc-exametazime and 99mTc-sestamibi. Wilcoxon matched-pairs test showed no significant difference between the 2 tracers (P = 0.48). HMPAO = exametazime; MIBI = sestamibi.

 


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  		FIGURE 5. Scatterplot with line of equality showing relationship between log net tumor-to-background ratios at examinations with 99mTc-exametazime and 99mTc-sestamibi in same patients. HMPAO = exametazime; MIBI = sestamibi.

 




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