Evaluation of Tc-99m-3PRGD2 Integrin Receptor Imaging in the Differential Diagnosis of Breast Lesions and Comparison With Mammography.

PURPOSE: The aims of this study were to evaluate and compare efficacies of Tc-99m-3PRGD2 integrin receptor imaging under variety of conditions for the diagnosis of breast lesions, in addition to comparison with mammography.

MATERIALS AND METHODS: Seventy-two female patients with established breast lesions were recruited. All patients were examined by Tc-99m-3PRGD2 integrin receptor imaging and mammography. Whole-body scan and SPECT/CT were acquired at dual time points of 2 and 4 h after injection using standard protocol. The processed images were evaluated by visual and semi-quantitative analysis. Mammography was performed using up and down and internal and external oblique views. The gold standard of diagnosis was based on histopathological findings.

RESULTS: Sensitivity greater than 85.0% and accuracy greater than 80.0% were observed under any technical method. For dense mammary gland, the sensitivity, specificity, and accuracy of Tc-99m-3PRGD2 SPECT/CT 4-h imaging and mammography were 95.2, 75.0, and 90.7%, and 71.4, 58.3, and 68.5% respectively. Combined two methods' sensitivity, specificity, and accuracy for detection of breast cancer can reach 98.3, 86.7, and 96.0%.

CONCLUSIONS: Tc-99m-3PRGD2-based molecular imaging is a sensitive method for the differential diagnosis of breast lesions. Particularly, Tc-99m-3PRGD2-SPECT/CT has better diagnostic value in dense mammary gland as compared with mammography. Combining two methods can significantly improve the diagnostic efficiency.