ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2026-9-1-33-42ojrdrt-510Research ArticleЯДЕРНАЯ МЕДИЦИНАNUCLEAR MEDICINEИспользование маммосцинтиграфии для оценки эффективности неоадъювантной химиотерапии у больных агрессивными биологическими подтипами рака молочной железыMammoscintigraphy in Patients with Aggressive Biological Subtypes of Breast Cancer: Assessment of Response to Neoadjuvant Chemotherapyhttps://orcid.org/0000-0001-9732-7920ХорошавинаА. А.KhoroshavinaA. A.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

horoshavina-lina-yan@yandex.ruhttps://orcid.org/0000-0002-7185-1967НовиковС. Н.NovikovS. N.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

https://orcid.org/0000-0002-6864-6348КрживицкийП. И.KrzhivitskiyP. I.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

ЖуковаЛ. А.ZhukovaL. A.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

https://orcid.org/0000-0002-3130-3624ПоповаН. С.PopovaN. S.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

https://orcid.org/0000-0002-9189-6417БрянцеваЖ. В.BryantsevaZh. V.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

https://orcid.org/0000-0003-0018-7197АкуловаИ. А.AkulovaI. A.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

https://orcid.org/0000-0002-4898-9159КриворотькоП. В.KrivorotkoP. V.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

https://orcid.org/0000-0002-1753-7926КанаевС. В.KanaevS. V.

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

 68 Leningradskaya St., Pesochny settlement, St. Petersburg, 197758

Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова Минздрава РоссииРоссияN.N. Petrov National Medical Research Center of OncologyRussian Federation202628032026913342Copyright © Хорошавина А.А., Новиков С.Н., Крживицкий П.И., Жукова Л.А., Попова Н.С., Брянцева Ж.В., Акулова И.А., Криворотько П.В., Канаев С.В., 20262026Хорошавина А.А., Новиков С.Н., Крживицкий П.И., Жукова Л.А., Попова Н.С., Брянцева Ж.В., Акулова И.А., Криворотько П.В., Канаев С.В.Khoroshavina A.A., Novikov S.N., Krzhivitskiy P.I., Zhukova L.A., Popova N.S., Bryantseva Z.V., Akulova I.A., Krivorotko P.V., Kanaev S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/510

Цель: Определить возможности использования маммосцинтиграфии (МСГ) с радиофармпрепаратом 99mTc-метокси-изобутил-изонитрил (99mTc-МИБИ) для оценки эффективности неоадъювантной химиотерапии (НАХТ) рака молочной железы (РМЖ) у пациенток с трижды негативным и HER2 позитивным биологическими подтипами. Материалы и методы: В исследование ретроспективно были включены 93 больные с морфологически верифицированным трижды негативным и HER2 позитивным раком молочной железы, которые получали неоадъювантную химиотерапию в НМИЦ онкологии им. Н.Н. Петрова в период с 2011 по 2018 гг. Маммосцинтиграфия была выполнена до начала лечения, после 2–3 и/или после 4–6 циклов НАХТ. Полученные данные были сопоставлены с результатами морфологического исследования операционного материала с установлением степени патоморфологического ответа опухоли по классификации Miller-Payne. Результаты: В целом, чувствительность и специфичность маммосцинтиграфии при диагностике полного ответа опухоли после завершения НАХТ были равны 83 % и 92 % соответственно. У больных с трижды негативным и HER2 положительным РМЖ чувствительность и специфичность составили 87 % и 92 %; 78 % и 91 % соответственно. При достижении полного сцинтиграфического ответа (V степень) после проведения 2–3 циклов НАХТ специфичность и точность положительных заключений маммосцинтиграфии достигли 100 % для обоих изученных подтипов РМЖ. Выводы: Полученные результаты указывают на высокие диагностические возможности маммосцинтиграфии в определении полного патоморфологического регресса опухоли после завершения НАХТ.

Purpose: To determine the diagnostic performance of mammoscintigraphy (SMG) with the 99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI) when used for assessment of the response to neoadjuvant chemotherapy (NACT) in patients with triple-negative and HER2-positive breast cancer (BC). Materials and methods: This retrospective study included 93 patients with morphologically verified triple-negative and HER2-positive breast cancer who received NACT between 2011 and 2018. Mammoscintigraphy was performed before treatment, after 2–3 and/or after 4–6 cycles of NACT. Diagnostic conclusions of SMG were compared with the results of morphological examination after surgical treatment at the end of NACT. The degree of pathological response to NACT was evaluated according to the Miller-Payne classification. Results: Overall, the sensitivity and specificity of SMG in predicting of complete pathologic tumor response after the completion of NACT were 83 % and 92 %, respectively. In patients with triple-negative and HER2-positive BC, sensitivity and specificity were 87 % and 92 %; 78 % and 91 %, respectively. When a complete scintigraphic response (grade V) was achieved after 2–3 cycles of NACT, the specificity and positive predictive value of SMG reached 100 % for both aggressive BC subtypes. Conclusions: The obtained results indicate the high diagnostic potential of SMG in predicting complete pathological tumor response to the NACT. Exceptional specificity and positive predictive value of SMG in the middle of the NACT make it promising tool in selection of BC patients for surgery de-escalation/elimination.

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The authors declare that there are no conflicts of interest present.