The Value Of 99mTc-MIBI Imaging In Assessing Response Of Breast Cancer To Neoadjuvant Chemotherapy And Compared With Clinical Examination And Ultrasonography

Objective To evaluate the value of 99mTc-methoxyisobutylisonitrile (MIBI) imaging in assessing response of breast cancer to neoadjuvant chemotherapy(NCT) compared with clinical examination and ultrasonography.Methods 57 breast cancer patients underwent 99mTc-MIBI imaging before and after 2 or 3 cycles of CEF or CMF or CTF chemotherapy, anterior planar scintigraphy were acquired at 60min after injection. Drawed the regions of interesting area(tumor tissue and the normal tissue on the other side).Tumor/normal tissue(T/N) ratio calculation>30%was considered as effective response. The pathological appearance was the standardization in assessing response of breast cancer to NCT. The pathological effect after chemotherapy atâ…¡andâ…¢grade was defined as markedly effective, the 1 and 0 grade as weakly ineffictent. Of these,35 patients underwent clinical examination, ultrasonography (measuring the largest tumor diameter)and 99mTc-MIBI imaging before and after chemotherapy. Clinical response was based on WHO criteria. The pathology was reviewed and immunostaining of P-glycoprotein(P-gP),multidrug resistance-associated protein(MRP) expression were obtained after surgery.99mTc-MIBI imaging compared with clinical examination and ultrasonography in assessing response of breast cancer to NCT.Results 1. The T/N (1h) decreased significantly after chemotherapy for the patients with markedly pathological effect(P<0.001),the rate of decreasion was increased with the increasion of pathological effect; The T/N did not have significantly changed for the patients without effect(P>0.05).2. The sensitivity, specificity,accuracy, positive predictive value and negative predictive value were 90%,79%.84%,88%,81%respectively for 99mTc-MIBI imaging in assessing response of neoadjuwant chemotherapy.3. The sensitivity, specificity and accuracy of 35 patients were 88%,78%,86%respectively for 99mTc-MIBI imaging with semiquantitative analysis;50%,64%and 54%respectively for clinical examination; 59%,70%,63%respectively for ultrasonography. The sensitivity and accuracy of 99mTc-MIBI imaging are significantly higher than clinical examination and ultrasonography. Conclusion 99mTc-MIBI imaging can effectively monitor the neoadjuvant chemotherapeutic curative effect in LABC and have higher accuracy compared with clinical examination and ultrasonography.