Skip to main content

Advertisement

SpringerLink
Log in

Background 99mTc-methoxyisobutylisonitrile uptake of breast-specific gamma imaging in relation to background parenchymal enhancement in magnetic resonance imaging

  • Nuclear Medicine
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

This study investigated factors that could affect background uptake of 99mTc- methoxyisobutylisonitrile (MIBI) on normal breast by breast-specific gamma imaging (BSGI). In addition, the impact of background 99mTc-MIBI uptake on the diagnostic performance of BSGI was further investigated.

Methods

One hundred forty-five women with unilateral breast cancer who underwent BSGI, MRI, and mammography were retrospectively enrolled. Background uptake on BSGI was evaluated qualitatively and quantitatively. Patients were classified into non-dense and dense breast groups according to mammographic breast density. Background parenchymal enhancement (BPE) was rated according to BI-RADS classification. The relationship of age, menopausal status, mammographic breast density, and BPE with background 99mTc-MIBI uptake was analyzed.

Results

Heterogeneous texture and high background uptake ratio on BSGI were significantly correlated with younger age (p < 0.001, respectively), premenopausal status (p < 0.001 and p = 0.003), dense breast (p < 0.001, respectively), and marked BPE (p < 0.001, respectively). On multivariate analysis, only BPE remained a significant factor for background MIBI uptake (p < 0.001).There was a significant reduction in positive predictive value (p = 0.024 and p = 0.002) as background MIBI uptake and BPE grade increased.

Conclusions

BPE on MRI was the most important factor for background MIBI uptake on BSGI. High background MIBI uptake or marked BPE can diminish the diagnostic performance of BSGI.

Key Points

• Age, menopause, density, and background parenchymal enhancement affect background MIBI uptake.

• BPE is an independent factor for background MIBI uptake on BSGI.

• Marked BPE may impair BSGI interpretation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

BSGI:

Breast-specific gamma imaging

BPE:

Background parenchymal enhancement

BI-RADS:

Breast Imaging-Reporting and Data System

References

  1. Okada RD, Glover D, Gaffney T, Williams S (1988) Myocardial kinetics of technetium-99 m-hexakis-2-methoxy-2-methylpropyl-isonitrile. Circulation 77:491–498

    Article  CAS  PubMed  Google Scholar 

  2. Ballinger J, Hua H, Berry B, Firby P, Boxen I (1995) 99Tcm-sestamibi as an agent for imaging P-glycoprotein-mediated multi-drug resistance: In vitro and in vivo studies in a rat breast tumour cell line and its doxirubicin-resistant variant. Nucl Med Commun 16:253–257

    Article  CAS  PubMed  Google Scholar 

  3. Delmon-Moingeon LI, Piwnica-Worms D, Van den Abbeele AD, Holman BL, Davison A, Jones AG (1990) Uptake of the cation hexakis (2-methoxyisobutylisonitrile)-technetium-99 m by human carcinoma cell lines in vitro. Cancer Res 50:2198–2202

    CAS  PubMed  Google Scholar 

  4. Aktolun C, Bayhan H, Kir M (1992) Clinical experience with Tc-99 m MIBI imaging in patients with malignant tumors preliminary results and comparison with TI-201. Clin Nucl Med 17:171–176

    Article  CAS  PubMed  Google Scholar 

  5. Brem RF, Floerke AC, Rapelyea JA, Teal C, Kelly T, Mathur V (2008) Breast-specific gamma imaging as an adjunct imaging modality for the diagnosis of breast cancer. Radiology 247:651–657

    Article  PubMed  Google Scholar 

  6. Goldsmith SJ, Parsons W, Guiberteau MJ et al (2010) SNM practice guideline for breast scintigraphy with breast-specific γ-cameras 1.0. J Nucl Med Technol 38:219–224

    Article  PubMed  Google Scholar 

  7. Lee CH, Dershaw DD, Kopans D et al (2010) Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol 7:18–27

    Article  PubMed  Google Scholar 

  8. Mann RM, Kuhl CK, Kinkel K, Boetes C (2008) Breast MRI: guidelines from the European society of breast imaging. Eur Radiol 18:1307–1318

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Kolb TM, Lichy J, Newhouse JH (2002) Comparison of the performance of screening mammography, physical examination, and breast us and evaluation of factors that influence them: an analysis of 27,825 patient evaluations1. Radiology 225:165–175

    Article  PubMed  Google Scholar 

  10. Rosenberg RD, Hunt WC, Williamson MR et al (1998) Effects of age, breast density, ethnicity, and estrogen replacement therapy on screening mammographic sensitivity and cancer stage at diagnosis: review of 183,134 screening mammograms in Albuquerque, New Mexico. Radiology 209:511–518

    Article  CAS  PubMed  Google Scholar 

  11. White E, Velentgas P, Mandelson MT et al (1998) Variation in mammographic breast density by time in menstrual cycle among women aged 40–49 years. J Nati Cancer Inst 90:906–910

    Article  CAS  Google Scholar 

  12. Miglioretti DL, Walker R, Weaver DL et al (2011) Accuracy of screening mammography varies by week of menstrual cycle. Radiology 258:372–379

    Article  PubMed Central  PubMed  Google Scholar 

  13. Baines CJ, Vidmar M, McKeown‐Eyssen G, Tibshirani R (1997) Impact of menstrual phase on false‐negative mammograms in the canadian national breast screening study. Cancer 80:720–724

    Article  CAS  PubMed  Google Scholar 

  14. Hambly NM, Liberman L, Dershaw DD, Brennan S, Morris EA (2011) Background parenchymal enhancement on baseline screening breast MRI: impact on biopsy rate and short-interval follow-up. AJR 196:218–224

    Article  PubMed  Google Scholar 

  15. DeMartini WB, Liu F, Peacock S, Eby PR, Gutierrez RL, Lehman CD (2012) Background parenchymal enhancement on breast MRI: impact on diagnostic performance. AJR 198:W373–W380

    Article  PubMed  Google Scholar 

  16. Müller-Schimpfle M, Ohmenhaüser K, Stoll P, Dietz K, Claussen CD (1997) Menstrual cycle and age: influence on parenchymal contrast medium enhancement in MR imaging of the breast. Radiology 203:145–149

    Article  PubMed  Google Scholar 

  17. Kajihara M, Goto M, Hirayama Y et al (2013) Effect of the Menstrual Cycle on Background Parenchymal Enhancement in Breast MR Imaging. Magn Reson Med Sci 12:39–45

    Article  PubMed  Google Scholar 

  18. Delille JP, Slanetz PJ, Yeh ED, Kopans DB, Garrido L (2005) Physiologic changes in breast magnetic resonance imaging during the menstrual cycle: perfusion imaging, signal enhancement, and influence of the T1 relaxation time of breast tissue. Breast J 11:236–241

    Article  PubMed  Google Scholar 

  19. Koo HR, Moon WK, Chun IK et al (2013) Background < sup > 18</sup > F-FDG uptake in positron emission mammography (PEM): Correlation with mammographic density and background parenchymal enhancement in breast MRI. Eur J Radiol 82:1738–1742

    Article  PubMed  Google Scholar 

  20. Cubuk R, Tasali N, Narin B, Keskiner F, Celik L, Guney S (2010) Correlation between breast density in mammography and background enhancement in MR mammography. Radiol Med 115:434–441

    Article  CAS  PubMed  Google Scholar 

  21. Ko ES, Lee BH, Choi HY, Kim RB, Noh W-C (2011) Background enhancement in breast MR: correlation with breast density in mammography and background echotexture in ultrasound. Eur J Radiol 80:719–723

    Article  PubMed  Google Scholar 

  22. Kim BS, Moon BI, Cha ES (2012) A comparative study of breast-specific gamma imaging with the conventional imaging modality in breast cancer patients with dense breasts. Ann Nucl Med 26:823–829

    Article  PubMed  Google Scholar 

  23. Pike M, Pearce C (2013) Mammographic density, MRI background parenchymal enhancement and breast cancer risk. Ann Oncol. doi:10.1093/annonc/mdt310

    PubMed Central  PubMed  Google Scholar 

  24. King V, Gu Y, Kaplan JB, Brooks JD, Pike MC, Morris EA (2012) Impact of menopausal status on background parenchymal enhancement and fibroglandular tissue on breast MRI. Eur Radiol 22:2641–2647

    Article  PubMed  Google Scholar 

  25. Kim MY, Choi N, Ko SM, Chung HW (2014) Background uptake of breast-specific gamma imaging: correlation with mammographic breast density and background enhancement of breast MRI. Clin Imaging. doi:10.1016/j.clinimag.2013.05.010

    Google Scholar 

  26. Hegenscheid K, Schmidt CO, Seipel R et al (2012) Contrast enhancement kinetics of normal breast parenchyma in dynamic MR mammography: effects of menopausal status, oral contraceptives, and postmenopausal hormone therapy. Eur Radiol 22:2633–2640

    Article  PubMed  Google Scholar 

  27. Rechtman LR, Lenihan MJ, Lieberman JH et al (2014) Breast-Specific Gamma Imaging for the Detection of Breast Cancer in Dense Versus Nondense Breasts. AJR 202:293–298

    Article  PubMed  Google Scholar 

  28. Mavi A, Cermik TF, Urhan M et al (2010) The effect of age, menopausal state, and breast density on 18 F-FDG uptake in normal glandular breast tissue. J Nucl Med 51:347–352

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Bom Sahn Kim. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This research was supported by grants from Ewha Womans University Research (1-2014-0642-001-1) and National Research Foundation (2012R1A1A1012913 and 2012M3A9B6055379) of South Korea. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Ewha Womans University, 911-1 Mok-Dong, Yangchun-Ku, Seoul, 158-710, Republic of Korea

    Hai-Jeon Yoon & Bom Sahn Kim

  2. Clinical Research Institute and Department of Conservative Dentistry, Ewha Womans University, Seoul, Republic of Korea

    Yemi Kim

  3. Department of Radiology, Ewha Womans University, Seoul, Republic of Korea

    Jee Eun Lee

Authors
  1. Hai-Jeon Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yemi Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jee Eun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bom Sahn Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bom Sahn Kim.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoon, HJ., Kim, Y., Lee, J.E. et al. Background 99mTc-methoxyisobutylisonitrile uptake of breast-specific gamma imaging in relation to background parenchymal enhancement in magnetic resonance imaging. Eur Radiol 25, 32–40 (2015). https://doi.org/10.1007/s00330-014-3400-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-014-3400-x

Keywords

Search

Navigation