Department of Biomorphological and Functional Sciences, Naples, Italy
Institute of Biostructures and Bioimages, National Research Council (CNR), Naples, Italy
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Kim, S.W., Park, S.S., Ahn, S.J., Identifi cation of an-giogenesis in primary breast carcinoma according to the image analysis (2002) Breast Cancer Res Treat, 74, pp. 121-129
Leonard, G.D., Fojo, T., Bates, S.E., The role of ABC transporters in clinical practice (2003) Oncologist, 8, pp. 411-424
Lowe, S.W., Cepero, E., Evan, G., Intrinsic tumour suppression (2004) Nature, 432, pp. 307-315
Mankoff, D.A., Dunnwald, L.K., Gralow, J.R., [Tc-99m]-sestamibi uptake and washout in locally advanced breast cancer are correlated with tumor blood flow (2002) Nucl Med Biol, 29, pp. 719-727
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Ogston, K.N., Miller, I.D., Schofield, A.C., Can patients' likelihood of benefi ting from primary chemotherapy for breast cancer be predicted before commencement of treatment? (2004) Breast Cancer Res Treat, 86, pp. 181-189
Peck, R.A., Hewett, J., Harding, M.W., Phase i and pharmacokinetic study of the novel MDR1 and MRP1 inhibitor biricodar administered alone and in combination with doxorubicin (2001) J Clin Oncol, 19, pp. 3130-3141
Prisack, H.B., Karreman, C., Modlich, O., Predictive biological markers for response of invasive breast cancer to anthracycline/cyclophosphamide-based primary (ra-dio-)chemotherapy (2005) Anticancer Res, 25, pp. 4615-4621
Reed, J.C., Drug Insight: Cancer therapy strategies based on restoration of endogenous cell death mechanisms (2006) Nat Clin Pract Oncol, 3, pp. 388-398
Sun, S.S., Hsieh, J.F., Tsai, S.C., Expression of mediated P-glycoprotein multidrug resistance related to Tc-99m MIBI scintimammography results (2000) Cancer Lett, 153, pp. 95-100
Trock, B.J., Leonessa, F., Clarke, R., Multidrug resistance in breast cancer: A meta-analysis of MDR1/gp170 expression and its possible functional signifi cance (1997) J Natl Cancer Inst, 89, pp. 917-931
Yoon, J.H., Bom, H.S., Song, H.C., Double-phase Tc-99m sestamibi scintimammography to assess angiogenesis and P-glycoprotein expression in patients with untreated breast cancer (1999) Clin Nucl Med, 24, pp. 314-318
Tc-99m-MIBI in the evaluation of breast cancer biology
A major area of interest in nuclear medicine is the scintigraphic in vivo evaluation of complex cellular processes involved in tumour growth, progression and response to treatment with the aim of defining the biological properties that may orient clinicians towards different adjustments of therapy in individual patients. In the last decade, Tc-99m-labelled lipophilic cations emerged as suitable tools to trace specific cellular processes and functions in a variety of malignant tumours, including breast cancer. Among these agents, Tc-99m-methoxyisobutylisonitrile (MIBI) is the most widely evaluated tracer and may serve as a paradigm for this class of compounds. Many clinical studies have been performed to correlate Tc-99m-MIBI uptake or clearance with histological, molecular and biochemical markers of various cellular processes, including apoptosis, proliferation, P-glycoprotein expression and neoangiogenesis. The final picture emerging from these studies is that the early tracer uptake reflects the mitochondrial status, which is affected by both apoptosis and proliferation, whereas the tracer clearance reflects the activity of drug transporters such as P-glycoprotein. On the basis of the imaging parameter chosen for the analysis of Tc-99m-MIBI scan in breast cancer patients, the biological information provided may be related to different cellular processes that ultimately govern tumour response to treatment.
Tc-99m-MIBI in the evaluation of breast cancer biology