PT  - JOURNAL ARTICLE
AU  - Rosa Sciuto
AU  - Rosella Pasqualoni
AU  - Serenella Bergomi
AU  - Germana Petrilli
AU  - Patrizia Vici
AU  - Franca Belli
AU  - Claudio Botti
AU  - Marcella Mottolese
AU  - Carlo L. Maini
TI  - Prognostic Value of <sup>99m</sup>Tc-Sestamibi Washout in Predicting Response of Locally Advanced Breast Cancer to Neoadjuvant Chemotherapy
DP  - 2002 Jun 01
TA  - Journal of Nuclear Medicine
PG  - 745--751
VI  - 43
IP  - 6
4099  - http://jnm.snmjournals.org/content/43/6/745.short
4100  - http://jnm.snmjournals.org/content/43/6/745.full
SO  - J Nucl Med2002 Jun 01; 43
AB  - This study evaluated the role of 99mTc-sestamibi washout in the prediction of pathologic tumor response to neoadjuvant chemotherapy in 30 patients with locally advanced breast cancer. Methods: Two 99mTc-sestamibi studies were performed before and after chemotherapy for each patient. Early (10 min) and delayed (240 min) planar breast views were acquired after a 740-MBq 99mTc-sestamibi intravenous injection, and the washout rate (WOR) was computed. All patients underwent radical mastectomy with pathologic evaluation of the residual tumor size. Results: The pretherapy 99mTc-sestamibi WOR ranged from 14% to 92% (mean ± SD, 50% ± 18%). At pathologic examination, 15 patients showed no tumor response to chemotherapy and 15 patients showed an objective response to chemotherapy. The pretherapy 99mTc-sestamibi study predicted chemoresistance (WOR > 45%) in 18 of 30 patients and no chemoresistance (WOR ≤ 45%) in 12 of 30 patients. When the WOR cutoff was set at >45%, the prognostic performance of the test was indicated by a sensitivity of 100%; a specificity of 80%; positive and negative predictive values of 83% and 100%, respectively; and a likelihood ratio of 5. The repeatability of the test was good, with 80%–93% interreader agreement (κ = 0.57−0.85). Posttherapy 99mTc-sestamibi studies confirmed the pretherapy study prediction in 29 of 30 patients. Conclusion: 99mTc-Sestamibi WOR is a reliable test for predicting tumor response to neoadjuvant chemotherapy. In fact, negative findings (WOR ≤ 45%) rule out chemoresistance and positive findings (WOR > 45%) indicate a high risk of chemoresistance.