Comparison Between Prone SPECT-Based Semi-Quantitative Parameters and MBI-Based Semi-Quantitative Parameters in Patients with Locally Advanced Breast Cancer

Molecular Imaging and Biology, vol. 26, pp. 926–933

Abstract

Abstract Purpose This study evaluates the semi-quantitative single-photon emission computed tomography (SPECT) parameters of prone SPECT using [99mTc]Tc-sestamibi and compares them with Molecular Breast Imaging (MBI)-derived semi-quantitative parameters for the potential use of response prediction in women with locally advanced breast cancer (LABC). Procedures Patients with proven LABC with a tumor ≥ 2 cm on mammography and an indication for MBI using [99mTc]Tc-sestamibi were prospectively enrolled. All patients underwent a prone SPECT/CT at 5 min (early exam) and an additional scan at 90 min (delayed exam) after injection of 600 MBq [99mTc]Tc-sestamibi to compose wash-out rates (WOR). All patients underwent MBI after early SPECT/CT. Volumes of interest of the primary tumor were drawn semi-automatically on early and delayed SPECT images. Semi-quantitative analysis included maximum and mean standardized uptake values (SUVmax, SUVmean,), functional tumor volume (FTVSPECT), total lesion mitochondrial uptake (TLMU), tumor-to-background ratios (TBRmax and TBRmean), WOR and coefficient of variation (COVSPECT). Subsequently, the FTVSPECT, TBRSPECT and COVSPECT were compared to FTVMBI, TBRMBI and COVMBI. Results Eighteen patients were included. Early SUVmax, and TBRmax showed significantly higher interquartile range (IQR) compared to SUVmean and TBRmean, respectively 2.22 (2.33) g/mL, 6.86 (8.69), 1.29 (1.39) g/mL and 3.99 (5.07) (median (IQR), p < 0.05). WOR showed a large IQR (62.28), indicating that there is WOR variation among the LABC patients. FTV showed no difference between MBI and early SPECT semi-quantitative parameter (p = 0.46). Conclusions In LABC patients it is feasible to obtain semi-quantitative parameters from prone SPECT/CT. The FTV derived from early prone SPECT/CT is comparable with MBI-based FTV. Studies with comprehensive clinical parameters are needed to establish the clinical relevance of these semi-quantitative parameters, including WOR, for response prediction before its use in clinical routine.

Authors 8

1. Alina van de Burgt corresponding Aachen Department of Nuclear Medicine Department of Radiology Section of Nuclear Medicine

   Leiden University Medical Center · Alrijne Ziekenhuis

   Affiliation as printed

   Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, The Netherlands. a.van_de_burgt@lumc.nl

   Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. a.van_de_burgt@lumc.nl

   Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, The Netherlands

2. Floris H. P. van Velden Aachen Department of Radiology Section of Nuclear Medicine

   Leiden University Medical Center

   Affiliation as printed

   Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands

3. Christinne L.S. Corion

   Medisch Centrum Haaglanden · Stichting Haaglanden Medisch Centrum

   Affiliation as printed

   Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands

4. Angela Collarino

   Agostino Gemelli University Polyclinic

   Affiliation as printed

   Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

5. Renato A Valdés Olmos Aachen Department of Radiology Section of Nuclear Medicine

   Leiden University Medical Center

   Affiliation as printed

   Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands

6. Frits Smit Aachen Department of Nuclear Medicine Department of Radiology Section of Nuclear Medicine

   Leiden University Medical Center · Alrijne Ziekenhuis

   Affiliation as printed

   Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, The Netherlands

   Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands

7. Lioe‐Fee de Geus‐Oei Aachen Department of Radiology Section of Nuclear Medicine

   Leiden University Medical Center · University of Twente · Delft University of Technology

   Affiliation as printed

   Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands

   Department of Radiation Science & Technology, Delft University of Technology, Delft, The Netherlands

   Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands

8. Lenka M. Pereira Arias‐Bouda Aachen Department of Nuclear Medicine Department of Radiology Section of Nuclear Medicine

   Leiden University Medical Center · Alrijne Ziekenhuis

   Affiliation as printed

   Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, The Netherlands

   Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands