Iranian Journal of Nuclear Medicine

Iranian Journal of Nuclear Medicine

Correlation of 99mTc[Tc]-MIBI washout kinetics with breast cancer histologic grade and ki-67 index

Document Type : Original Article

Authors
Mohammad Sadegh Piltan 1
Mohammad Esmlami-Kalantari 1
Mohammad Ali Shafaei 1
Farshid Gheisari 2
1 Department of Physics, Yazd University, Yazd, Iran
2 Department of Nuclear Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
10.22034/irjnm.2024.129576.1618
Abstract
Introduction: 99mTc[Tc]-MIBI breast scintimammography offers a noninvasive method for assessing breast cancer biology. Studies suggest a potential prognostic value in washout analysis, as accelerated washout correlates with high histologic grade. The study examines whether the washout rate of 99mTc[Tc]-MIBI, a marker of mitochondrial dysfunction, correlates with the ki-67 index, a reliable predictive tool for breast cancer that estimates cellular proliferation.
Methods: In this study, 30 cases of breast cancer who were intact, without previous breast operation, prior chemotherapy, and previous radiotherapy, had prone scintimammagraphy. The diagnosis was approved by biopsy. The standard 20 mCi 99mTc[Tc]-MIBI was applied to all patients, and after 15 min and 60 min of injection, two imaging series were taken at each time. After different methods of calculation of washout, the washout percentage has been correlated with the Ki-67 index in the patients.
Results: All breast cancers showed significant tracer uptake at 15 minutes, mostly correlated with tumor angiogenesis. Imaging at 60 minutes revealed decreased activity, indicating a positive correlation between higher 99mTc[Tc]-MIBI washout and higher breast cancer grade as indicated by the Ki-67 index.
Conclusion: The significant association between increased 99mTc[Tc]-MIBI washout and increased cancer grade indicates that washout analysis may have potential prognostic utility before or during surgical treatment. Additionally, there is a suggestion of increased tumor grade correlating with increased mitochondrial dysfunction. While further prospective validation is necessary, this pilot study demonstrates that washout kinetics could serve as a noninvasive imaging biomarker for breast cancer grade to supplement clinical management algorithms.
Keywords
99mTc[Tc]-MIBI
Scintimammography
Breast cancer grade
Washout kinetics
Ki-67 index
Subjects
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