Abundant blood supply and low P-glycoprotein expression on dynamic 99mTc-MIBI imaging predicted better chemotherapy sensitivity for a breast cancer patient: A case report

Abstract

A patient with a history of breast cancer underwent 3-phase 99mTc-methylene diphosphonate (MDP) imaging followed 3 d later by 3-phase 99mTc-sestamibi (MIBI) imaging. During the vascular and blood-pool phases, a lymph node over the right clavicle was seen on both the 99mTc-MIBI and the 99mTc-MDP scans at as early as 30 s and then became hotter. Four months after receiving chemotherapy, the patient achieved a complete response. The lymph node over the right clavicle vanished on ultrasound examination. The similar distribution of the bloodpool phase between the 99mcTc-MDP and 99mcTc-MIBI scans indicated that 99mcTc-MIBI may similarly provide information on vascularization of the lymph node. In addition to indicating vascularization, our 99mcTc-MIBI protocol may simultaneously provide information on P-glycoprotein expression important for predicting chemotherapy sensitivity. With information on the resistance of a tumor to drugs and the environment in which it dwells, chemotherapy sensitivity might be predicted more precisely. © 2012 by the Society of Nuclear Medicine, Inc.