99mTc-sestamibi scintigraphy used to evaluate tumor response to neoadjuvant chemotherapy in locally advanced breast cancer: A quantitative analysis

Koga,Katia H.; Moriguchi,Sonia M.; Nahás Neto,Jorge; Verzinhasse Peres,Stela; Tinóis Da Silva,Eduardo; Sarri,Almir J.; Michelin,Odair C.; Alenkar Marques,Mariangela E.; Griva,Beatriz L.

doi:10.3892/ol_00000067

99mTc-sestamibi scintigraphy used to evaluate tumor response to neoadjuvant chemotherapy in locally advanced breast cancer: A quantitative analysis

Authors:
- Katia H. Koga
- Sonia M. Moriguchi
- Jorge Nahás Neto
- Stela Verzinhasse Peres
- Eduardo Tinóis Da Silva
- Almir J. Sarri
- Odair C. Michelin
- Mariangela E. Alenkar Marques
- Beatriz L. Griva
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Affiliations: Department of Nuclear Medicine, Botucatu Medical School, Sao Paulo State University (UNESP), São Paulo, Brazil
Published online on: March 1, 2010 https://doi.org/10.3892/ol_00000067
Pages: 379-382

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Abstract

To evaluate the tumor response to neoadjuvant chemotherapy, 99mTc-sestamibi breast scintigraphy was proposed as a quantitative method. Fifty-five patients with ductal carcinoma were studied. They underwent breast scintigraphy before and after neoadjuvant chemotherapy, along with clinical assessment and surgical specimen analysis. The regions of interest on the lesion and contralateral breast were identified, and the pixel counts were used to evaluate lesion uptake in relation to background radiation. The ratio of these counts before to after neoadjuvant chemotherapy was assessed. The decrease in uptake rate due to chemotherapy characterized the scintigraphy tumor response. The Kruskal-Wallis test was used to compare the mean scintigraphic tumor response and histological type. Dunn's multiple comparison test was used to detect differences between histological types. The Mann-Whitney test was used to compare means between quantitative and qualitative variables: scintigraphic tumor response vs. clinical response and uptake before chemotherapy vs. scintigraphic tumor response. The Spearman's test was used to correlate the quantitative variables of clinical reduction in tumor size and scintigraphic tumor response. All of the variables compared presented significant differences. The change in 99mTc-sestamibi uptake noted on breast scintigraphy, before to after neoadjuvant chemotherapy, may be used as an effective method for evaluating the response to neoadjuvant chemotherapy, since this quantification reflects the biological behavior of the tumor towards the chemotherapy regimen. Furthermore, additional analysis on the uptake rate before chemotherapy may accurately predict treatment response.

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