Prediction of chemotherapeutic response by Technetium 99m--MIBI scintigraphy in breast carcinoma patients

Cancer. 2001 Jul 15;92(2):232-9. doi: 10.1002/1097-0142(20010715)92:2<232::aid-cncr1314>;2-g.


Background: Significance of Technetium 99m ((99m)Tc)-MIBI scintigraphy in the prediction of response to anthracylines and taxanes (both are substrates for P-glycoprotein [P-gp]) as well as relation between (99m)Tc-MIBI uptake and P-gp or MDR1 mRNA expression in tumors were studied in patients with breast carcinoma.

Methods: Forty-six female patients with locally advanced (n = 15) or metastatic (n = 31) breast carcinoma were recruited in this study. Before chemotherapy (epirubicin and cyclophosphamide [n = 20] or decetaxel [n = 26]), (99m)Tc-MIBI scintigraphy was performed to obtain the T/N (tumor to normal tissue) ratios of (99m)Tc-MIBI uptake at 10 minutes (T/N[e]) and at 180 minutes (T/N[d]) after the (99m)Tc-MIBI injection. Expression of MDR1 mRNA and P-gp in tumors (n = 32) were determined by a quantitative real-time polymerase chain reaction and immunohistochemistry, respectively.

Results: Clinical significance of T/N(e) and T/N(d) ratios in the prediction of chemotherapeutic response was evaluated using the arbitrary cutoff values of 3.0 for T/N(e) ratios and 2.0 for T/N(d) ratios. Positive predictive value, negative predictive value, and diagnostic accuracy of T/N(d) ratios (81.0%, 96.0%, and 89.1%, respectively) were higher, although statistically not significant, than those of T/N(e) ratios (73.3%, 77.4%, and 76.1%, respectively), and these values were not affected by type of chemotherapy. MDR1 mRNA levels were not significantly different between the lesions with high (> or = 2.0) and low (< 2.0) T/N(d) ratios, but P-gp expression was significantly (P < 0.01) higher in the lesions with low T/N(d) ratios than in those with high T/N(d) ratios.

Conclusions: T/N(d) ratios determined by (99m)Tc-MIBI scintigraphy are useful in the prediction of response to chemotherapy with epirubicin and cyclophosphamide or docetaxel as well as in the in vivo evaluation of P-gp expression status in tumors in patients with locally advanced or recurrent breast carcinoma.

Publication types

  • Evaluation Study

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B / biosynthesis
  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / biosynthesis
  • Adult
  • Aged
  • Antibiotics, Antineoplastic / pharmacology
  • Antibiotics, Antineoplastic / therapeutic use*
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / drug therapy
  • Bridged-Ring Compounds / pharmacology
  • Bridged-Ring Compounds / therapeutic use*
  • Carcinoma / diagnostic imaging*
  • Carcinoma / drug therapy
  • Female
  • Genes, MDR / genetics
  • Humans
  • Middle Aged
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • RNA, Messenger / biosynthesis
  • Radionuclide Imaging
  • Radiopharmaceuticals* / pharmacokinetics
  • Taxoids*
  • Technetium Tc 99m Sestamibi* / pharmacokinetics
  • Treatment Outcome


  • ATP Binding Cassette Transporter, Subfamily B
  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • Antibiotics, Antineoplastic
  • Bridged-Ring Compounds
  • RNA, Messenger
  • Radiopharmaceuticals
  • Taxoids
  • taxane
  • Technetium Tc 99m Sestamibi