Initial In Vivo Quantification of Tc-99m Sestamibi Uptake as a Function of Tissue Type in Healthy Breasts Using Dedicated Breast SPECT-CT.

Abstract

A pilot study is underway to quantify in vivo the uptake and distribution of Tc-99m Sestamibi in subjects without previous history of breast cancer using a dedicated SPECT-CT breast imaging system. Subjects undergoing diagnostic parathyroid imaging studies were consented and imaged as part of this IRB-approved breast imaging study. For each of the seven subjects, one randomly selected breast was imaged prone-pendant using the dedicated, compact breast SPECT-CT system underneath the shielded patient support. Iteratively reconstructed and attenuation and/or scatter corrected images were coregistered; CT images were segmented into glandular and fatty tissue by three different methods; the average concentration of Sestamibi was determined from the SPECT data using the CT-based segmentation and previously established quantification techniques. Very minor differences between the segmentation methods were observed, and the results indicate an average image-based in vivo Sestamibi concentration of 0.10 ± 0.16 μCi/mL with no preferential uptake by glandular or fatty tissues.

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Citation

Published Version (Please cite this version)

10.1155/2012/146943

Publication Info

Mann, Steve D, Kristy L Perez, Emily KE McCracken, Jainil P Shah, Terence Z Wong and Martin P Tornai (2012). Initial In Vivo Quantification of Tc-99m Sestamibi Uptake as a Function of Tissue Type in Healthy Breasts Using Dedicated Breast SPECT-CT. J Oncol, 2012. p. 146943. 10.1155/2012/146943 Retrieved from https://hdl.handle.net/10161/12981.

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Scholars@Duke

Mann

Steven Mann

Assistant Professor of Radiology
Wong

Terence Z. Wong

Professor of Radiology
  1. Anatomic/functional oncologic Imaging: SPECT/CT, PET/CT, novel PET radiotracers

    2. Radiotheranostics, Radionuclide therapy of cancer, Radiation Therapy Planning

    3. Imaging biomarkers for guiding treatment strategies

    4. Multicenter clinical trial development (NCI National Clinical Trials Network)
Tornai

Martin Paul Tornai

Adjunct Associate Professor in the Department of Radiology

The major research focus of my laboratory concerns high resolution and sensitivity molecular imaging of normalcy and/or disease in the breast using dedicated molecular 3D imaging techniques. Particular attention is paid to improved patient comfort such that no breast compression is necessary, which then dictates novel physics and engineering approaches to obtaining the highest quality data. The term "molecular imaging" means determining the spatial distribution of biological materials based on their molecular characteristics. Two examples include: the in vivo detection and spatial localization of tracer quantities of discretely emitted nuclear radiation which can be used to quantitatively measure aspects of the biological system (e.g. reaction kinetics, hyper/hypo-metabolism, etc.), and the in vivo spatial localization of objects based on their intrinsic physical properties, e.g. differentiation of skin, fat and connective tissue based on differences in their intrinsic electron densities.

Two classes of devices have been developed, are in refinement and are undergoing patient studies: (1) a dedicated, fully 3D, volumetric imaging Single Photon Emission Computed Tomograph (SPECT) device which produces functional molecular images with high resolution and sensitivity; and (2) a dedicated, fully 3D, volumetric x-ray CT device which incorporates a novel quasi-monochromatic x-ray source allowing more optimal imaging with lower radiation doses which produces molecular anatomical images. Along with geometric calibration objects, small animals and cadaveric breast tissue samples have been scanned, yielding high resolution and high quality in vivo images. Patient imaging has successfully begun on these novel developed systems. We have integrated a flexible patient bed to help comfortably position patients in each systems' field of view. Further, the individual systems have been integrated to form a hybrid SPECT/CT mammotomograph providing inherently coregistered, fully 3D, complementary molecular/anatomical information for the same patient and in a common field of view. These technologies could be used for diagnostic purposes, monitoring therapy and/or treatment planning, screening difficult or otherwise inconclusive breasts or scanning women at high risk for breast cancer. Due to the very low x-ray radiation doses possible to obtain the 3D images, the CT system could potentially be used to screen the population at large.


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