Evaluation of 99mTc-MIBI Scintimammorgraphy in the Diagnosis of Primary Breast Cancer: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Min , GUO Youmin , GUO Xiaojuan , CHEN Min , ZHANG Shaojuan

Imaging Center; the 1st affiliated Hospital of Xi’an Jiaotong University; 710061; Xi’an; China;

Corresponding author：

Keywords：

Breast carcinoma; 99mTc-MIBI scintimammorgraphy; Meta-analysis

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Objective 　To determine the value of 99m Tc-MIBI scintimmmography in diagnosing primary breast cancer and axillary lymph node metastases.
Methods 　Independent, prospective, blinded studies were selected from the Cochrane Library, MEDLINE, Springer, Elsevier and China National Knowledge Infrastructure, Sensitivity, specificity, and accuracy of scintimammography were estimated by comparison with the results of biopsy. Subsequently, the characteristics of included articles such as sensitivity, specificity of 99m

Citation： LIU Min,GUO Youmin,GUO Xiaojuan,CHEN Min,ZHANG Shaojuan. Evaluation of 99mTc-MIBI Scintimammorgraphy in the Diagnosis of Primary Breast Cancer: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2005, 05(7): 536-542. doi: Copy

1.	Rodes N, Lopez M, Pearson D. The impact of breast cancer screening on survival: a 5-to10-year follow-up up study[J].Cancer,1986;57(3):581-585.
2.	Wingo PA, Tong T, Bolden S. Cancer statistics,1995[J].CA Cancer J Clin,1995;45(1):8-30.
3.	Jense OM, Esteve J, Moller H, Renard H. Cancer in European community and its member states[J].Eur J Cancer,1990;26(11-12): 1167-1256.
4.	Müller ST, Guth-Tougelides B, Creutzig H. Imaging of malignant tumors with MIBI-99mTc SPECT[J] .J Nucl Med,1987;28(2):562p.
5.	Waxman A, Ashok G, Kooba A. The use of 99mTc-methoxy isobutyl isontrile(MIBI) in the evaluation of patients with primary carcinoma of the breast[J]. Clin Nucl Med, 1992; 9(7): 761p.
6.	Campeau RJ, Kronemer KA. Sutherland CM. Concordant uptake of Tc-99m sestamibi and Tl-201in unsuspected breast tumor[J]. Clin Nucl Med,1992;179(12):936-937.
7.	Khalkhali I, Mena I, Diggles L. Review of imaging techniques for the diagnosis of breast cancer :a new role of prone scintimsmmography using technetium-99m sestamibi[J]. Eur J Nucl Med, 1994;21(4): 357-362.
8.	Kao CH,Wang SJ,Liu TJ.The use of technetium-99m-metheoxyisobutilisonitrile breast scintigraphy to evaluate palpable breast masses[J]. Eur J Nucl Med, 1994;21(5):432-436.
9.	Deeks JJ. systematic reviews of evaluations of diagnostic and screening tests. In:Egger M,Smith SD,Altman G,editors:systematic reviews. London; BMJ Publishing, 2001, 248-282.
10.	Liu GJ, Wu TX. Summary ROC curve-diagnostic test method of Meta-analysis[J]. Chinese Journal of Evidence-Based Medicine, 2003; 3(1): 41-44.
11.	T Justin Clark,Christopher H. Mann,Neil Shan Khalid .K,Fujian S,Janesh KG. Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial cancer : a systematic quantitative review[J]. BJOG, 2002;109,313-321.
12.	McAlister Fa,Straus SE,Sackett DL.Why we need large simple studies of the clinical examination:the problem and a proposed solution[J]. Lancet, 1999;354(9191):1721-1724.
13.	Moses Le,Shapiro D,Littenberg B.Combining independent studies of a diagnostic test into a summary ROC curve: data analytic approaches and some additional considerations[J].StatMed,1993;129 (14) :1293-1316.
14.	Chen LC, Yin YQ, Chen JX, Sun XG,Yang X, Liu WG.The usefulness of technetium-99m-MIBI scintimammography in diagnosis of breast cancer: using surgical histopathologic diagnosis as the gold standard[J]. Anticancer research, 1997;17(3B);1695-1698.
15.	Raymond T,Andre R,Raymond L, Sophie T , Jacques C,Jean L.Technetium-99m-sestamibi prone scintimammography to detect primary breast cancer and axillary lymph node involvement[J]. J Nucl Med,1995;36 (10): 1758-1765.
16.	Iraj Khalkhali,John C,Ismael M,Linda D,Rose V,Herman V,et al.Technetium-99m-sestamibi scintimammo -graphy of breast lesions:clinical and pathological follow-up[J].J Nucl Med,1995;36(10):1784-1789.
17.	J.Villanueva-Meyer J,Leonard MH,Briscoe F,Cesani,SA,Rhoden M,D.Cowan..Mammoscintigraphy with technetium-99m-sestamibi in suspected breast cancer[J].J Nucl Med,1996;37(6):926-930.
18.	Douglas H,Robert S,David C, Linda L.Technetium-99m sestamibi scitimammography:the influence of histopathological characteristics ,leision size and the presence of carcinoma in situ in the detection if breast carcinoma[J]. Eur J Nucl Med, 1999;26(11):1475-1481.
19.	Palmedo H, Biersack H, Lastoria S, Maublant J, Prats E,Stegner H. Scintimammography with technetium-99m methoxyisobutylisontrile:results of a prospective European multicentre trial[J]. EurJ Nucl Med, 1998;25(4):375-385.
20.	Danielsson R, Bone B, Perbeck L, Aspelin P. Sensitivity and specificity of planar scintimammography with 99mTc-sestamibi[J]. Acta Radiol, 1999;40(4):394-399.
21.	Cwikla B, Buscombe R, Parbhoo P, Davidson T, Holloway B, Hilson W. What is the best way to find breast cancer[J]? Nucl Med Commun,2000;21 (4):388.
22.	Prast E,Banzo J,MeronnoE, Herranz R, Carril JM.99m-Tc-MIBIscintimammorgraphy as a complement of the mammography in patients with suspected breast cancer[J]. Breast, 2001;10 (2)109-116.
23.	Bagni B,Franceschetto A,Casolo A, M De Santis, I Bagni, F Pansini, and C Di Leo.Scintimammography with 99mTc-MIBI and magnetic resonance imaging in the evaluation of breast cancer[J]. Eur J Nucl Med Mol Imaging, 2003;30 (10): 1383-1388.
24.	Prast E,Carril J,Meronoe E, Herranz R,Banzo J, YE Gtemegmmt.A spainish multicenter scintigraphic study of the breast using Tc99mMIBI : Report of results[J]. Rev Esp Med Nucl, 1998,17(5):338-350.
25.	Massimo I,Silvana DV,Albina R,Leonardo P,Francesco DS,Francesca DGet al. Scintimammography with 99mTc-MIBI versus dynamic MRI for non-invasive characterization of breast masses[J]. Eur J Nucl Med, 2001;28(1):56-63.
26.	Tofani A, Sciuto R, Semprebene A, Festa A, Pasqualoni R, Giunta S.99mTc-MIBI Scintimam mography in 300 consecutive patients: factors that may affect accuracy[J]. Nucl Med Commun, 1999;20 (12):1113-1121.
27.	Yang XW, Jin G,Wang ZC,Yang WL.Detection of primary breast cancer and axillary lyphm node matastasis by 99mTc-MIBI prone scintimammography[J]. Chin Jof General Surgey, 2000,9(6):538-540.
28.	Sergey M,Judith S,Maya C,Shlomo L and Ernesto L. Technetium-99m-MIBI scintimammorgrahy in palpable and nonpalpable breast lesions[J]. J Nucl Med, 1998;39(1):86-91.
29.	Palmedo H, Schomburg A, Grunwald F,Mallmann P,Krebs D,Biersack HJ.Technetium-99m-MIBI scintimammorgray for suspicious breast lesions[J].J Nucl Med,1996;37(4):626-630.
30.	Zagorski.S,Cirangle.P,Delaplain.C,S.Kim ,J.Kavolus.Sestamibi scintimammogrphy in the evalution of breast pathology[J]. Current Surgery, 1999;56(7):438-450.
31.	Deng NY, Zhang JS,TangY.99mTc-MIBI scintimammography in the evaluation of breast cancer[J]. China General Surgery, 2003;12(10):784-785.
32.	Guo DS, WangYT, Lu GZ.Value of 99mTc-MIBI scintimammography in the differential diagnosis between bengin breast tumor ,breast cancer and lymph node involvement[J]. China Oncology, 2000;10 (16) : 542-544.
33.	Chen J,Wu H, Hu J Zhou J. 99mTc-MIBI mammoscintigraphy in differentiation of nodular lesions of breast and detection of axillary lymph nodes metastasis from breast cancer[J]. Radiol Practice, 2003;18(1):59-61.
34.	Omar A,Teresa M,LB,Delgado,Jorge H,Levent K,Augusto L,et al.Is 99mTc-MIBI scintimammography complementary to conventional mamm-ography for detecting breast cancer in patients with palpable masses[J]? J Nucl Med, 2001;42 (11):1614-1621.
35.	Sun SS,Jih Fang Hsieh,Shin-chuanTsai,HO YJ,LEE JK,Kao CH.The role of Tc-99m methoxysiobutylisonitrile scintimam-mography as compared to mammography in evaluating palpable breast masses of Taiwanese women[J]. Anticancer research, 2000;20(3B):2133-2136.
36.	Isabel U,Jose M,Remedios O, Rosario G , OlgaT, Alfonso M. Optimization of X-ray mammography and technetium-99m methoxy-isobutylisonitrile scintimammography in the diagnosis of non-palpable breast lesions[J]. Eur J Nucl Med, 1998;25(5):491-496.
37.	JM Carril, R Gomez-Barquin, R Quirce, O Tabuenca, I Uriarte, and A Montero.Contribution of 99mTc-MIBI scintimammography to the diagnosis of non-palpable breast lesions in relation to mammographic probability of malignancy[J]. Anticancer research, 1997;17(3B):1677-1682.
38.	Raymond T,Andre R,Sophie T,Raymond L,Jacques C,Jean L,et al.Metasttic axillary lymph node technetium-99m-MIBI imaging in primary breast cancer[J]. J Nucl Med, 1998;39(7):459-464.
39.	Lam WW, Yang WT, Chan YL, Stewart IE, Metreweli C, King W. Detection of axillary lymph node metastases in breast carcinoma by technetium-99m sestamibi breast scintigraphy,ultrasound and conventional mammography[J]. Eur J Nucl Med, 1996;23(3):498-503.
40.	Perre CI, Rutter JE, Vos PA, de Hooge P.Technetium-99m-sestamibi uptake in axillary lymph node metastases in breast cancer patients[J]. Eur J Surg Oncol, 1997;23(2)142-144.
41.	Tolmos J, Khalkhali I, Vargas H, Stuntz M, Cutrone J, Mishkin F,et al..Detection od axillary lymph node metastases of breast carcinoma with technetium-99m sestamibi scintimammography[J]. Am Surg, 1997;63 (10):850-853.
42.	Orazio S,Francesco S,Roberta D,Rosanna T,Pina C et al.Technetium-99m sestamibi imaging in the detection of axillary lymph node involvement[J].J Nucl Med,1995;36(10):1758-1765.
43.	Adler LP, Crowe JP, al-Kaisi NK, Sunshine JL.Evaluation of breast masses and axillary lymph nodes with (F-18) 2-deoxy-2-fluoro-d-glucose PET[J]. Radiology,1993;187(3):743-750.
44.	Rodier JF, Routiot T, Mignotte H, Janser JC, Bremond A, David E, et al. Lymphatic mapping and sentinel node biopsy of operable breast cancer[J]. World Journal of Surgery, 2000; 24(10):2313-2323.

1. Rodes N, Lopez M, Pearson D. The impact of breast cancer screening on survival: a 5-to10-year follow-up up study[J].Cancer,1986;57(3):581-585.
2. Wingo PA, Tong T, Bolden S. Cancer statistics,1995[J].CA Cancer J Clin,1995;45(1):8-30.
3. Jense OM, Esteve J, Moller H, Renard H. Cancer in European community and its member states[J].Eur J Cancer,1990;26(11-12): 1167-1256.
4. Müller ST, Guth-Tougelides B, Creutzig H. Imaging of malignant tumors with MIBI-99mTc SPECT[J] .J Nucl Med,1987;28(2):562p.
5. Waxman A, Ashok G, Kooba A. The use of 99mTc-methoxy isobutyl isontrile(MIBI) in the evaluation of patients with primary carcinoma of the breast[J]. Clin Nucl Med, 1992; 9(7): 761p.
6. Campeau RJ, Kronemer KA. Sutherland CM. Concordant uptake of Tc-99m sestamibi and Tl-201in unsuspected breast tumor[J]. Clin Nucl Med,1992;179(12):936-937.
7. Khalkhali I, Mena I, Diggles L. Review of imaging techniques for the diagnosis of breast cancer :a new role of prone scintimsmmography using technetium-99m sestamibi[J]. Eur J Nucl Med, 1994;21(4): 357-362.
8. Kao CH,Wang SJ,Liu TJ.The use of technetium-99m-metheoxyisobutilisonitrile breast scintigraphy to evaluate palpable breast masses[J]. Eur J Nucl Med, 1994;21(5):432-436.
9. Deeks JJ. systematic reviews of evaluations of diagnostic and screening tests. In:Egger M,Smith SD,Altman G,editors:systematic reviews. London; BMJ Publishing, 2001, 248-282.
10. Liu GJ, Wu TX. Summary ROC curve-diagnostic test method of Meta-analysis[J]. Chinese Journal of Evidence-Based Medicine, 2003; 3(1): 41-44.
11. T Justin Clark,Christopher H. Mann,Neil Shan Khalid .K,Fujian S,Janesh KG. Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial cancer : a systematic quantitative review[J]. BJOG, 2002;109,313-321.
12. McAlister Fa,Straus SE,Sackett DL.Why we need large simple studies of the clinical examination:the problem and a proposed solution[J]. Lancet, 1999;354(9191):1721-1724.
13. Moses Le,Shapiro D,Littenberg B.Combining independent studies of a diagnostic test into a summary ROC curve: data analytic approaches and some additional considerations[J].StatMed,1993;129 (14) :1293-1316.
14. Chen LC, Yin YQ, Chen JX, Sun XG,Yang X, Liu WG.The usefulness of technetium-99m-MIBI scintimammography in diagnosis of breast cancer: using surgical histopathologic diagnosis as the gold standard[J]. Anticancer research, 1997;17(3B);1695-1698.
15. Raymond T,Andre R,Raymond L, Sophie T , Jacques C,Jean L.Technetium-99m-sestamibi prone scintimammography to detect primary breast cancer and axillary lymph node involvement[J]. J Nucl Med,1995;36 (10): 1758-1765.
16. Iraj Khalkhali,John C,Ismael M,Linda D,Rose V,Herman V,et al.Technetium-99m-sestamibi scintimammo -graphy of breast lesions:clinical and pathological follow-up[J].J Nucl Med,1995;36(10):1784-1789.
17. J.Villanueva-Meyer J,Leonard MH,Briscoe F,Cesani,SA,Rhoden M,D.Cowan..Mammoscintigraphy with technetium-99m-sestamibi in suspected breast cancer[J].J Nucl Med,1996;37(6):926-930.
18. Douglas H,Robert S,David C, Linda L.Technetium-99m sestamibi scitimammography:the influence of histopathological characteristics ,leision size and the presence of carcinoma in situ in the detection if breast carcinoma[J]. Eur J Nucl Med, 1999;26(11):1475-1481.
19. Palmedo H, Biersack H, Lastoria S, Maublant J, Prats E,Stegner H. Scintimammography with technetium-99m methoxyisobutylisontrile:results of a prospective European multicentre trial[J]. EurJ Nucl Med, 1998;25(4):375-385.
20. Danielsson R, Bone B, Perbeck L, Aspelin P. Sensitivity and specificity of planar scintimammography with 99mTc-sestamibi[J]. Acta Radiol, 1999;40(4):394-399.
21. Cwikla B, Buscombe R, Parbhoo P, Davidson T, Holloway B, Hilson W. What is the best way to find breast cancer[J]? Nucl Med Commun,2000;21 (4):388.
22. Prast E,Banzo J,MeronnoE, Herranz R, Carril JM.99m-Tc-MIBIscintimammorgraphy as a complement of the mammography in patients with suspected breast cancer[J]. Breast, 2001;10 (2)109-116.
23. Bagni B,Franceschetto A,Casolo A, M De Santis, I Bagni, F Pansini, and C Di Leo.Scintimammography with 99mTc-MIBI and magnetic resonance imaging in the evaluation of breast cancer[J]. Eur J Nucl Med Mol Imaging, 2003;30 (10): 1383-1388.
24. Prast E,Carril J,Meronoe E, Herranz R,Banzo J, YE Gtemegmmt.A spainish multicenter scintigraphic study of the breast using Tc99mMIBI : Report of results[J]. Rev Esp Med Nucl, 1998,17(5):338-350.
25. Massimo I,Silvana DV,Albina R,Leonardo P,Francesco DS,Francesca DGet al. Scintimammography with 99mTc-MIBI versus dynamic MRI for non-invasive characterization of breast masses[J]. Eur J Nucl Med, 2001;28(1):56-63.
26. Tofani A, Sciuto R, Semprebene A, Festa A, Pasqualoni R, Giunta S.99mTc-MIBI Scintimam mography in 300 consecutive patients: factors that may affect accuracy[J]. Nucl Med Commun, 1999;20 (12):1113-1121.
27. Yang XW, Jin G,Wang ZC,Yang WL.Detection of primary breast cancer and axillary lyphm node matastasis by 99mTc-MIBI prone scintimammography[J]. Chin Jof General Surgey, 2000,9(6):538-540.
28. Sergey M,Judith S,Maya C,Shlomo L and Ernesto L. Technetium-99m-MIBI scintimammorgrahy in palpable and nonpalpable breast lesions[J]. J Nucl Med, 1998;39(1):86-91.
29. Palmedo H, Schomburg A, Grunwald F,Mallmann P,Krebs D,Biersack HJ.Technetium-99m-MIBI scintimammorgray for suspicious breast lesions[J].J Nucl Med,1996;37(4):626-630.
30. Zagorski.S,Cirangle.P,Delaplain.C,S.Kim ,J.Kavolus.Sestamibi scintimammogrphy in the evalution of breast pathology[J]. Current Surgery, 1999;56(7):438-450.
31. Deng NY, Zhang JS,TangY.99mTc-MIBI scintimammography in the evaluation of breast cancer[J]. China General Surgery, 2003;12(10):784-785.
32. Guo DS, WangYT, Lu GZ.Value of 99mTc-MIBI scintimammography in the differential diagnosis between bengin breast tumor ,breast cancer and lymph node involvement[J]. China Oncology, 2000;10 (16) : 542-544.
33. Chen J,Wu H, Hu J Zhou J. 99mTc-MIBI mammoscintigraphy in differentiation of nodular lesions of breast and detection of axillary lymph nodes metastasis from breast cancer[J]. Radiol Practice, 2003;18(1):59-61.
34. Omar A,Teresa M,LB,Delgado,Jorge H,Levent K,Augusto L,et al.Is 99mTc-MIBI scintimammography complementary to conventional mamm-ography for detecting breast cancer in patients with palpable masses[J]? J Nucl Med, 2001;42 (11):1614-1621.
35. Sun SS,Jih Fang Hsieh,Shin-chuanTsai,HO YJ,LEE JK,Kao CH.The role of Tc-99m methoxysiobutylisonitrile scintimam-mography as compared to mammography in evaluating palpable breast masses of Taiwanese women[J]. Anticancer research, 2000;20(3B):2133-2136.
36. Isabel U,Jose M,Remedios O, Rosario G , OlgaT, Alfonso M. Optimization of X-ray mammography and technetium-99m methoxy-isobutylisonitrile scintimammography in the diagnosis of non-palpable breast lesions[J]. Eur J Nucl Med, 1998;25(5):491-496.
37. JM Carril, R Gomez-Barquin, R Quirce, O Tabuenca, I Uriarte, and A Montero.Contribution of 99mTc-MIBI scintimammography to the diagnosis of non-palpable breast lesions in relation to mammographic probability of malignancy[J]. Anticancer research, 1997;17(3B):1677-1682.
38. Raymond T,Andre R,Sophie T,Raymond L,Jacques C,Jean L,et al.Metasttic axillary lymph node technetium-99m-MIBI imaging in primary breast cancer[J]. J Nucl Med, 1998;39(7):459-464.
39. Lam WW, Yang WT, Chan YL, Stewart IE, Metreweli C, King W. Detection of axillary lymph node metastases in breast carcinoma by technetium-99m sestamibi breast scintigraphy,ultrasound and conventional mammography[J]. Eur J Nucl Med, 1996;23(3):498-503.
40. Perre CI, Rutter JE, Vos PA, de Hooge P.Technetium-99m-sestamibi uptake in axillary lymph node metastases in breast cancer patients[J]. Eur J Surg Oncol, 1997;23(2)142-144.
41. Tolmos J, Khalkhali I, Vargas H, Stuntz M, Cutrone J, Mishkin F,et al..Detection od axillary lymph node metastases of breast carcinoma with technetium-99m sestamibi scintimammography[J]. Am Surg, 1997;63 (10):850-853.
42. Orazio S,Francesco S,Roberta D,Rosanna T,Pina C et al.Technetium-99m sestamibi imaging in the detection of axillary lymph node involvement[J].J Nucl Med,1995;36(10):1758-1765.
43. Adler LP, Crowe JP, al-Kaisi NK, Sunshine JL.Evaluation of breast masses and axillary lymph nodes with (F-18) 2-deoxy-2-fluoro-d-glucose PET[J]. Radiology,1993;187(3):743-750.
44. Rodier JF, Routiot T, Mignotte H, Janser JC, Bremond A, David E, et al. Lymphatic mapping and sentinel node biopsy of operable breast cancer[J]. World Journal of Surgery, 2000; 24(10):2313-2323.

Chinese Journal of Evidence-Based Medicine

Evaluation of 99mTc-MIBI Scintimammorgraphy in the Diagnosis of Primary Breast Cancer: A Meta-analysis

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