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

Alina van de Burgt*, Floris H.P. van Velden, Christinne L.S. Corion, Angela Collarino, Renato A.Valdés Olmos, Frits Smit, Lioe Fee de Geus-Oei, Lenka M. Pereira Arias-Bouda

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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 (TBRmaxand 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.

Original languageEnglish
Pages (from-to)926-933
Number of pages8
JournalMolecular Imaging and Biology
Volume26
Issue number6
DOIs
Publication statusPublished - Dec 2024

Keywords

  • Locally advanced breast cancer
  • Molecular breast imaging
  • Quantitative SPECT
  • Response prediction
  • SPECT/CT
  • [Tc]Tc-sestamibi

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