Clinical utility of scintimammography: From the Anger-camera to new dedicated devices

• Published in: Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment Vol. 569; no. 2; pp. 281 - 285
• Main Authors: Schillaci, Orazio, Danieli, Roberta, Romano, Pasquale, Cossu, Elsa, Simonetti, Giovanni
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 20.12.2006
• Subjects: Breast cancer; Dedicated high-resolution gamma-cameras; Scintimammography; Scintimammography; Dedicated high-resolution gamma-cameras; Breast cancer
• ISSN: 0168-9002; 1872-9576
• DOI: 10.1016/j.nima.2006.08.029

Scintimammography is a functional imaging technique which uses a radiation detection camera to detect radionuclide tracers in the patient's breasts. Tracers are designed to accumulate in tumours more than in healthy tissue: the most used are Tc-99 m sestamibi and Tc-99 m tetrofosmin. Scintimammography is useful in some clinical indications as an adjunct to mammography: it is recommended for those lesions where additional information is required to reach a definitive diagnosis. Patients with dubious mammograms may benefit from this test, as well as women with dense breasts or with implants. Scintimammography is a valuable diagnostic tool also in patients with locally advanced breast cancer for monitoring and predicting response to neoadjuvant chemotherapy. Nevertheless, using an Anger-camera this technique shows a high sensitivity only for cancers >1 cm. Since other modalities are increasingly employed for the early identification of small abnormalities, the issue of detecting small cancers is critical for the future development and clinical utility of breast imaging with radiopharmaceuticals. The use of high-resolution cameras dedicated for breast imaging is the best option to improve the detection of small cancers: they allow higher flexibility in patient positioning, and the availability of mammography-like projections. Moreover, the detector can be placed directly in contact with the breast allowing a mild compression with reduction of the breast's thickness, thus increasing the target-to-background ratio and the sensitivity. These new devices have the potential of increasing the total number of breast scintigraphies performed thereby enhancing the role of nuclear medicine in breast cancer imaging.