Nuclear Medicine in Breast Cancer Diagnostics: Primary Tumor and Lymphatic Metastasis

The purpose of the study: to assess the possibility of using nuclear medicine techniques at the stages of diagnosis and treatment of breast cancer. Materials and Methods: The study included 290 patients with breast cancer and 70 patients with benign breast tumors. The study was used as a radiopharmaceutical 99mTc-MIBI, 199Tl for imaging tumors and colloid 99mTc-Aloteh for visualization sentinel lymph nodes (SLN), colloid was injected peritumoral in four points to 80 MBq one day prior to the planned operation. Results: The sensitivity of SPECT using both 99mTc-MIBI and 199Tl for breast cancer detection was shown to be rather high, being 98.5% and 98%, respectively. It should be noted that the sensitivity of SPECT in detection of small tumors (less than 1 cm in diameter) and multicentric tumors was not high irrespective of the radioisotope used (60% and 65% with 99mTc-MIBI and 65% and 59% with 199Tl, respectively). The difference in the sensitivity was found between 99mTc-MIBI and 199T for the detection of regional lymph node metastasis (91% vs 70%). SLN were detected in 31 patients. The most commonly SLN were defined in the axillary region of 96.7%. In 22 (70.9%) patients there was no metastasis SLN. The sensitivity of the method was 91.2%, specificity of 100%. Conclusion: The specificity of SPECT with 199Tl was higher than that with 99mTc-MIBI. The data obtained show that SPECT with 199Tl can be recommended for its use as an additional breast cancer detection method in cases when other imaging techniques and histological findings are not accurate enough. The clinical study of 99mTc-Aloteh, a new radiopharmaceutical agent, has shown that the studied colloid has high uptake level in SLN and can be successfully used for visualization of SLN in patients with breast cancer

Nuclear Medicine in Breast Cancer Diagnostics: Primary Tumor and Lymphatic Metastasis

The purpose of the study: to assess the possibility of using nuclear medicine techniques at the stages of diagnosis and treatment of breast cancer. Materials and Methods: The study included 290 patients with breast cancer and 70 patients with benign breast tumors. The study was used as a radiopharmaceutical 99mTc-MIBI, 199Tl for imaging tumors and colloid 99mTc-Aloteh for visualization sentinel lymph nodes (SLN), colloid was injected peritumoral in four points to 80 MBq one day prior to the planned operation. Results: The sensitivity of SPECT using both 99mTc-MIBI and 199Tl for breast cancer detection was shown to be rather high, being 98.5% and 98%, respectively. It should be noted that the sensitivity of SPECT in detection of small tumors (less than 1 cm in diameter) and multicentric tumors was not high irrespective of the radioisotope used (60% and 65% with 99mTc-MIBI and 65% and 59% with 199Tl, respectively). The difference in the sensitivity was found between 99mTc-MIBI and 199T for the detection of regional lymph node metastasis (91% vs 70%). SLN were detected in 31 patients. The most commonly SLN were defined in the axillary region of 96.7%. In 22 (70.9%) patients there was no metastasis SLN. The sensitivity of the method was 91.2%, specificity of 100%. Conclusion: The specificity of SPECT with 199Tl was higher than that with 99mTc-MIBI. The data obtained show that SPECT with 199Tl can be recommended for its use as an additional breast cancer detection method in cases when other imaging techniques and histological findings are not accurate enough. The clinical study of 99mTc-Aloteh, a new radiopharmaceutical agent, has shown that the studied colloid has high uptake level in SLN and can be successfully used for visualization of SLN in patients with breast cancer

The use of (99m}Tc-Al[2]O[3] for detection of sentinel lymph nodes in breast cancer

Purpose: to study the feasibility of using the new radiopharmaceutical based on the technetium-99m-labeled gamma-alumina for identification of sentinel lymph nodes (SLNs) in breast cancer patients. The study included two groups of breast cancer patients who underwent single photon emission computed tomography (SPECT) and intraoperaive gamma probe identification of sentinel lymph nodes (SLNs). To identify SLNs, the day before surgery Group I patients (n=34) were injected with radioactive {99m}Tc-Al[2]O[3], and Group II patients (n=30) received 99mTc-labeled phytate colloid. A total of 37 SLNs were detected in Group I patients. The number of identified SLNs per patient ranged from 1 to 2 (the average number of identified SLNs was 1.08). Axillary lymph nodes were the most common site of SLN localization. 18 hours after {99m}Tc-Al[2]O[3] injection, the percentage of its accumulation in the SLN was 7-11% (of the counts in the injection site) by SPECT and 17-31% by gamma probe detection. In Group II SLNs were detected in 27 patients. 18 hours after injection of the phytate colloid the percentage of its accumulation in the SLN was 1.5-2% out of the counts in the injection site by SPECT and 4-7% by gamma probe. The new radiopharmaceutical based on the {99m}Tc-Al[2]O[3] demonstrates high accumulation in SLNs without redistribution through the entire lymphatic basin. The sensitivity and specificity of {99m}Tc-Al[2]O[3] were 100% for both SPECT and intraoperative gamma probe identification

The use of (99m}Tc-Al[2]O[3] for detection of sentinel lymph nodes in breast cancer

Purpose: to study the feasibility of using the new radiopharmaceutical based on the technetium-99m-labeled gamma-alumina for identification of sentinel lymph nodes (SLNs) in breast cancer patients. The study included two groups of breast cancer patients who underwent single photon emission computed tomography (SPECT) and intraoperaive gamma probe identification of sentinel lymph nodes (SLNs). To identify SLNs, the day before surgery Group I patients (n=34) were injected with radioactive {99m}Tc-Al[2]O[3], and Group II patients (n=30) received 99mTc-labeled phytate colloid. A total of 37 SLNs were detected in Group I patients. The number of identified SLNs per patient ranged from 1 to 2 (the average number of identified SLNs was 1.08). Axillary lymph nodes were the most common site of SLN localization. 18 hours after {99m}Tc-Al[2]O[3] injection, the percentage of its accumulation in the SLN was 7-11% (of the counts in the injection site) by SPECT and 17-31% by gamma probe detection. In Group II SLNs were detected in 27 patients. 18 hours after injection of the phytate colloid the percentage of its accumulation in the SLN was 1.5-2% out of the counts in the injection site by SPECT and 4-7% by gamma probe. The new radiopharmaceutical based on the {99m}Tc-Al[2]O[3] demonstrates high accumulation in SLNs without redistribution through the entire lymphatic basin. The sensitivity and specificity of {99m}Tc-Al[2]O[3] were 100% for both SPECT and intraoperative gamma probe identification

The first experience of using of {99}mTc-Al[2]O[3] for detection of sentinel lymph nodes in breast cancer

Purpose: to study the feasibility of using the new radiopharmaceutical based on the technetium-99m-labeled gamma-alumina for identification of sentinel lymph nodes (SLNs) in breast cancer patients. Materials and methods. The study included two groups of breast cancer patients who underwent single photon emission computed tomography (SPECT) and intraoperaive gamma probe identification of sentinel lymph nodes (SLNs). To identify SLNs, the day before surgery Group I patients (n=34) were injected with radioactive {99m}Tc-Al[2]0[3], and Group II patients (n=30) received {99m}Tc-labeled phytate colloid. Results. A total of 37 SLNs were detected in Group I patients. The number of identified SLNs per patient ranged from 1 to 2 (the average number of identified SLNs was 1.08). Axillary lymph nodes were the most common site of SLN localization. At 18 hours after {99m}Tc-Al[2]0[3] injection, the percentage of its accumulation in the SLN was 7-11% (of the counts in the injection site) by SPECT and 17-31% by gamma probe detection. In Group II patients, SLNs were detected in 27 patients. At 18 hours after injection of the phytate colloid, the percentage of its accumulation in the SLN was 1.5-2% out of the counts in the injection site by SPECT and 4-7% by gamma probe. Conclusion. The new radiopharmaceutical based on the {99m}Tc -Al[2]0[3] demonstrates high accumulation in SLNs without redistribution through the entire lymphatic basin. Sensitivity and specificity of {99m}Tc -Al[2]0[3] were 100% for both SPECT and intraoperative gamma probe identification

Radiopharmaceuticals for SPECT Cancer Detection

The purpose of the study was to assess the efficacy of single photon emission computed tomography (SPECT) with {199}Tl and {99}mTc-MIBI in the detection of breast, laryngeal and hypopharyngeal cancers. A total of 220 patients were included into the study: 120 patients with breast lesions (100 patients with breast cancer and 20 patients with benign breast tumors) and 100 patients with laryngeal/hypopharyngeal diseases (80 patients with laryngeal/hypopharyngeal cancer and 20 patients with benign laryngeal/hypopharyngeal lesions). No abnormal {199}Tl uptake was seen in all patients with benign breast and laryngeal lesions, indicating a 100% specificity of {199}Tl SPECT. In the breast cancer patients, the increased {199}Tl uptake in the breast was visualized in 94.8% patients, {99m}Tc-MIBI-in 93.4% patients. The increased {199}Tl uptake in axillary lymph nodes was detected in 60% patients, and {99m}Tc-MIBI-in 93.1% patients. In patients with laryngeal/hypopharyngeal cancer, the sensitivity of SPECT with {199}Tl and {99m}Tc-MIBI was 95%. The {199}Tl SPECT sensitivity in identification of regional lymph node metastases in the patients with laryngeal/hypopharyngeal cancer was 75% and the {99m}Tc-MIBI SPECT sensitivity was 17%. The data obtained showed that SPECT with {199}Tl and {99m}Tc-MIBI can be used as one of the additional imaging methods in detection of tumors

ВЛИЯНИЕ ТРАНСКРИПЦИОННЫХ ФАКТОРОВ, VEGF И ПРОТЕИНАЗ НА прогрессирование РАКА ПОЧКИ

Introduction. The efficacy of anticancer treatment depends on biological factors of tumor.The aim of the study was to determine the activity of proteasomes and calpains and to  reveal their association with VEGF, HIF-1α and NF-κΒ expressions in normal, primary and metastatic renal cell carcinoma (RCC) tissues.Methods. Ninety-three patients with renal cell carcinoma were included into the study. The expression levels of transcription factor and VEGF were measured using ELISA kits. The  levels of proteasome subunits were measured by Western Blotting. Proteasome and calpain  activities were determined using specific fluorogenic  substrates.Results. We revealed inactivation of proteolysis in patients with kidney cancer. Disease advance was associated with a significant depression of cellular proteolysis and increase in  transcription and growth factor levels in primary kidney cancer tissues. The proteolysis  activation was found in metastatic tissues.Conclusions. Our results suggest that NF-κΒ, HIF-1α and VEGF transcription factors and intracellular proteolytic systems are involved in kidney cancer progression.Введение. Эффективность противоракового лечения зависит от биологических факторов опухоли.Цель исследования – определить активность протеасом и кальпаинов и выявить их связь с содержанием  VEGF, HIF-1α и NF-κΒ в опухолевых, неизмененных и метастатических тканях карциномы почек (RCC).Материал и методы. В исследование были включены 93 пациента с почечно-клеточным раком. Содержание  транскрипционных факторов и VEGF определяли методом ИФА. Количественный состав протеасом исследовали  методом Вестерн-блоттинг. Активность протеасомы и кальпаина определяли с использованием специфического флюорогенного субстрата.Результаты. Выявлена инактивация протеолиза у пациентов с раком почки. Прогрессирование заболевания  было связано со значительным снижением уровня клеточного протеолиза и ростом содержания  транскрипционных и ростовых факторов в тканях первичной опухоли. Активация протеолиза была обнаружена в метастатических тканях.Выводы. В результате проведенного исследования показано, что факторы транскрипции NF-κΒ, HIF-1α, VEGF и внутриклеточные протеолитические системы участвуют в прогрессировании рака почки

Clinicopathological features of nonspecific invasive breast cancer according to its molecular subtypes

The aim of the present study was to investigate the clinical and morphological features of nonspecific invasive breast cancer according to its molecular subtypes. Materials and Methods: 163 women with nonspecific invasive breast cancer (T1–4N0–3M0) were included in the present study. Luminal A type of breast cancer was detected in 101 women, luminal B type — in 23 women, overexpression of HER2/neu was identified in 14 women and triple-negative cancer — in 25 women. Results: The study revealed that various molecular subtypes of breast cancer differ in the morphological structure, the expression characteristics of the primary tumor and the rate of lymphogenous and hematogenous metastasis. Lymphogenous metastases were more frequently (in 71%) detected in HER2/neu overexpressing breast cancer than in luminal A (41%), luminal B (39%) and triple-negative tumors (40%). Hematogenous metastasis did not depend on the morphological structure of carcinoma infiltrative component, the state of tumor stroma as well as the proliferative activity in all the investigated groups. Conclusion: The revealed clinicopathological characteristics of different molecular subtypes of invasive breast cancer allow to predict the possible outcome of the disease and select personalized treatment strategy for patients more reasonably

ОТДАЛЕНЫЕ РЕЗУЛЬТАТЫ КОМПЛЕКСНОГО ЛЕЧЕНИЯ БОЛЬНЫХ РАКОМ МОЛОЧНОЙ ЖЕЛЕЗЫ С ИСПОЛЬЗОВАНИЕМ РАЗЛИЧНОГО ОБЪЕМА АДЪЮВАНТНОЙ ЛУЧЕВОЙ ТЕРАПИИ

The study included 103 patients with stage T1–3N0–3M0 breast cancer who received multimodality treatment including neo- and adjuvant chemotherapy according to CMF and CAF schedules, hormonal therapy, radical mastectomy and adjuvant radiation therapy. All patients were divided into two groups depending on the volume of postoperative radiation therapy. Group I patients (n=48) received 40–44 Gy external radiation therapy to the areas of potential regional spread. Group II patients (n-55) additionally received radiation therapy delivered to postoperative scar area at a total dose of 38–44 isoGy. The  comparative analysis of long-term results showed a significant decrease in the rate of local recurrences and increase in the 5-year recurrence-free and overall survival rates in the group of breast cancer patients who received adjuvant radiation therapy to the areas of potential regional spread and postoperative scar. In order to plan adequate radiotherapyand to minimize local radiation-induced reactions, it is necessary to consider clinical and morphological prognostic factors.В исследовании представлены результаты комплексного лечения 103 больных РМЖ стадии T1–3N0–3M0 c использованием нео- и адъювантной химиотерапии по схемам CMF, CAF и/или гормонотерапии, радикальной мастэктомии и адъювантной лучевой терапии. В зависимости от объема послеоперационной лучевой терапии больные были распределены на две группы: в I группе (n=48) проводилась дистанционная лучевая терапия (ДЛТ) на зоны регионарного лимфооттока в стандартном режиме СОД 40–44 Гр; во II группе (n-55) дополнительно проводилось облучение области послеоперационного рубца СОД 38–44 изоГр. Сравнительный анализ отдаленных результатов показал  значимое снижение числа местных рецидивов, а также повышение показателей  пятилетней безрецидивной и общей выживаемости в группе больных РМЖ, получавших адъювантную лучевую терапию на зоны регионарного лимфооттока и область послеоперационного рубца. Для планирования адекватного облучения и минимизации местных лучевых реакций нормальных тканей необходимо учитывать клинико-морфологические факторы прогноза заболевания