The Clinical Value of Breast Specific Gamma Imaging and Positron Imaging: An Update

In the management of patients with breast cancer (BC), a mammography contributed to screen an early-stage patient, to plan a therapy strategy, to evaluate a therapy outcome, to detect a recurrence, and to reduce a mortality. Currently, various imaging modalities, such as CT, MR, Ultrasound (US), SPECT/CT, PET/CT, PET/MR have been utilized for the man-agement of BC patients. In order to overcome a limited spatial resolution and sensitivity of whole-body systems in nuclear medicine imaging, dedicated breast imaging modalities were developed. One is a gamma imaging system with single/dual head scintillation detec-tors or semiconductor detectors associated with light compression device for breast paren-chyma. Radiopharmaceutical for the gamma imaging is 99mTc-sestamibi. Another is a positron imaging system with opposite-type panel detectors and ring-shaped type detec-tors. Radiopharmaceutical for positron imaging is 18F-fluorodeoxyglucose. The breast -spe-cific gamma and positron imaging systems were utilized mainly to detect small lesions less than 1 cm in diameter especially in patients with dense breast, to evaluate an effect of pre-operative neo-adjuvant therapy, to plan surgical procedures (conservative-surgery vs mas-tectomy), and to detect a recurrence. By combining higher sensitivity and spatial resolution scanners with new radiopharmaceuticals, an information on molecular-level pathology of BC is increasingly available in an individual patient. This article reviewed clinical impact and future perspective of this field. Semin Nucl Med 52:619-627 (c) 2022 The Author. Published by Elsevier Inc.