Molecular Breast Imaging Using Tc99m-Sestamibi and Breast Optimized Detector Systems

Main Article Content

Douglas A. Kieper


Mammography and ultrasound are common anatomical imaging procedures used to detect breast cancer. While screening mammography, especially when combined with ultrasound, has demonstrated the ability to detect non-palpable breast cancer, these modalities still suffer from some significant limitations.


Download data is not yet available.

Article Details

How to Cite
Kieper DA. Molecular Breast Imaging Using Tc99m-Sestamibi and Breast Optimized Detector Systems. BKK Med J [Internet]. 2012 Feb. 20 [cited 2023 Dec. 1];3(1):89. Available from:
Reviews Article


1. Berg WA, Blume JD, Cormack JB, et al. Combined screening with ultrasound and mammography vs. mammography alone in women at elevated risk of breast cancer. JAMA 2008;299:2151-63.
2. Brem RF, Schoonjans JM, Kieper DA, et al. Highresolution scintimammography: a pilot study. J Nucl Med 2002;43:909-15.
3. Brem R, Kieper D. Rapelyea J, et al. Evaluation of a high-resolution, breast-specific, small-field-of-view gamma camera for the detection of breast cancer. Nuclear Instruments and Methods 2003;497:168-73.
4. Scopinaro F, Pani R, de Vincentis G, et al. High-resolution scintimammography improves the accuracy of Tc-99m methoxyisobutylisonitrile scintimammography:use of a new dedicated gamma camera. Eur J Nucl Med 1999;26:1279-88.
5. Garibaldi F, Cisbani E, Cusanno F, et al. Optimization of compact gamma cameras for breast imaging. Nucl. Instr. & Meth. Phys Res Sec A 2001;471:222.
6. Coover LR, Caravaglia G, Kuhn P. Scintimammography with dedicated breast camera detects and localizes occult carcinoma. J Nucl Med 2004;45:553-8.
7. Rhodes DJ, O’Connor MK, Phillips SW, et al. Molecular breast imaging: a new technique using technetium Tc 99m scintimammography to detect small tumors of the breast. Mayo Clin Proc 2005;80:24-30.
8. O’Connor MK, Phillips SW, Hruska CB, et al. Molecular breast imaging: advantages and limitations of a scintimammographic technique in patients with small breast tumors. Breast J 2007;13:3-11.
9. Brem R, Kieper D, Rapelyea J, et al. High-Resolution Scintimammography as an Adjunct for the Diagnosis of Breast Cancer in High-Risk Women with Normal Mammograms and Physical Examination. RSNA Annual Meeting Chicago IL, December 1-5, 2003.
10. Wymer DC, Green T, Keppel C, et al. Evaluation of clinically occult mammographic abnormalities using scintimammography with enhanced gamma camera imaging. SNM Annual Meeting. New Orleans LA, June 21-25 2003.
11. Chen S. Liu W. Mao Y, et al. 99m Tc-MIBI and 99m Tc-MDP scintimammography for detecting breast carcinoma. Chin Med J 2000;113:400-3.
12. Pena Y, Coca MA, Perera A, et al. Use of Tc-99m glucoheptonate scintimammography as a potential alternative for the diagnosis of breast cancer. Clin Nucl Med 2005;30:126-7.
13. Goldsmith SJ, Parsons W, Guiberteau MJ, et al. Society of Nuclear Medicine. SNM practice guideline for breast scintigraphy with breast-spe- cific gamma-cameras 1.0. J Nucl Med Technol 2010; 38:219-24.
14. Carvalho PA, Chiu ML, Kronauge JF, et al. Subcellular distribution and analysis of technetium-99m-MIBI in isolated perfused rat hearts. J Nucl Med 1992;33:1516-21.
15. Crane P, Laliberte R, Heminway S, et al. Effect of mitochondrial viability and metabolism on technetium- 99msestamibi myocardial retention. Eur J Nucl Med 1993;20:20-5.
16. Piwnica-Worms D, Kronauge JF, Chiu ML. Uptake and retention of hexakis (2-methoxyisobutyl isonitrile) technetium (I) in cultured chick myocardial cells. Mito chondrial and plasma membrane potential dependence. Circulation 1990;82:1826-38.
17. Cutrone JA, Yospur LS, Khalkhali I, et al. Immunohisto logic assessment of technetium-99m-MIBI uptake in benign and malignant breast lesions. J Nucl Med 1998;39:449-53.
18. Khalkhali I, Mena I, Jouanne E, et al. Prone scintimammography in patients with suspicion of carcinoma of the breast. J Am Coll Surg 1994;178:491-7.
19. Scopinaro F, Schillaci O, Scarpini M, et al. Technetium-99m sestamibi: an indicator of breast cancer invasiveness. Eur J Nucl Med 1994;21:984-7.
20. Piwnica-Worms D, Chiu ML, Budding M, et al. Functional imaging of multidrug-resistant P-glycoprotein with an organotechnetium complex. Cancer Res 1993;53:977-84.
21. Ballinger JR, Hua HA, Berry BW, et al. 99Tcm-Sestamibi as an agent for imaging P-glycoprotein-mediated multidrug resistance: in vitro and in vivo studies in a rat breast tumour cell line and its doxorubicin-resistant variant. Nucl Med Commun 1995;16:253-7.
22. Moretti JL, Caglar M, Boaziz C, et al. Sequential functional imaging with technetium-99m hexakis-2-methoxyisobutylisonitrile and indium-111 octreotide:can we predict the response to chemotherapy in small cell lung cancer? Eur J Nucl Med 1995;22:177-80.
23. Kieper D, Green TD, Hoefer R, et al. Data analysis methods for a small field-of-view combined scintimammography/digital X-ray system in breast lesion manage ment. Nucl Instr and Meth A 2003497:135-40.
24. Sciuto R, Pasqualoni R Bergomi S, et al. Germana. Prognostic Value of 99mTc-Sestamibi Washout in Predicting Response of Locally Advanced Breast Cancer to Neoadjuvant Chemotherapy. J Nucl Med 2002;43:745-51.
25. Hruska CB, O’Connor MK, Collins DA. Comparison of small field of view gamma camera systems for scintimammography. Nucl Med Commun 2006:441-5.
26. Hruska C, et al. Molecular Breast Imaging: Use of a Dual-Head Dedicated Gamma Camera to Detect Small Breast Tumors. AJR 2008;191:1805-15.
27. Böhm-Vélez M, Kieper DA, Williams MB, et al. A Clinical Evaluation of Breast Tissue Uptake of Tc99m-Sestamibi as a Function of Injected Dose. Breast Cancer Imaging:State of the Art 2011. National Institutes of Health, Washington DC. April 2011.
28. SNM Guideline for Breast Scintigraphy with Breast-Specific Gamma Cameras 1.0. Society of Nuclear Medicine. Issued June 4, 2010.
29. Del Vecchio S, Salvatore M. 99mTc-MIBI in the evaluation of breast cancer biology. Eur J Nucl Med Mol Imaging 2004;31(Suppl. 1):88-96.
30. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 2007;37:1-332.
31. Hendrick E. Radiation doses and cancer risks from breast imaging studies. Radiology 2010;257:246-53.
32. Radiation Dose in Perspective. Health Physics Society via web search. October 13th 2010.
33. NIH RSC Report: Improving Informed Consent for Research Radiation Studies. Published October 17, 2001. Web search conducted October 4, 2010. http://drs.ors.