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Suleyman Demirel Universitesi TIP FAKULTESI DERGISI: 2007 Eylul; 14(3) Meme kanserinin tespitinde Tc-99m MIBI meme sintigrafisi, mamografi ve ultrasonografi yontemlerinin etkinliklerinin karsilastirilmasi Sevim Sureyya Cerci*, Celal Cerci**, Bahattin Baykal***, Mustafa Yildiz*, Feride Meltem Ozbek*, F. Nilgun Kapicioglu****, Ahmet Yesildag***, Hasan Erol Eroglu** * Suleyman Demirel Universitesi Tip Fakultesi, Nukleer Tip Anabilim Dali. Isparta, ** Suleyman Demirel Universitesi Tip Fakultesi, Genel Cerrahi Anabilim Dali. Isparta, ***Suleyman Demirel Universitesi Tip Fakultesi, Radyoloji Anabilim Dali. Isparta, ****Suleyman Demirel Universitesi Tip Fakultesi, Patoloji Anabilim Dali. Isparta, Ozet Meme kanseri tum dunya kadinlari arasinda en sik gorulen kanser turu olmakla birlikte bu hastaliga bagli mortalite orani, erken tani ve tedavideki gelismeler sayesinde azalmistir. Mamografi ve ultrasonografi meme kanseri taramasi ve tanisinda en sik kullanilan goruntuleme yontemleri olmasina karsin her iki yontemde de benign ve malign lezyonlar benzer gorunumde olabilmekte ve bu da gereksiz fazla sayida negatif biyopsi alinmasina sebep olmaktadir. Non-invaziv yontemler kullanilarak, biyopsiden yararlanabilecek hastalarin secimi ve negatif sonuclu biyopsi sayisinin azaltilmasi onemlidir. Bu amacla cesitli radyonuklidler kullanilarak meme sintigrafisi ve pozitron emisyon tomografi yontemleri uygulanmaktadir. Bu calismada memede ele gelen kitle nedeniyle kliniklere basvuran hastalarin lezyonlarinin benign, malign ayriminda mamografi, ultrasonografi ve Technetium-99m- hexakis-2-methoxy-isobutyl-isonitrile (Tc-99m MIBI) ile yapilan meme sintigrafisi bulgulari retrospektif olarak degerlendirilmis ve etkinliklerinin karsilastirilmasi amaclanmistir. Bu amacla biyopsi sonuclari mevcut olan 84 olgunun (yas ortalamasi 49.63±11.33 yil) mamografi, ultrasonografi ve Tc-99m MIBI meme sintigrafisi sonuclari degerlendirildi. Elli dort hastanin histopatolojik incelemesi benign, 30 hastanin malign olarak tespit edildi. Meme sintigrafisinde malignite icin sensitivite %93, spesifite %91, mamografide sensitivite %83, spesifite %85 ve ultrasonografide sensitivite %87, spesifite %89 olarak bulundu. Her uc yontem kombine edildiginde ise sensitivite ve spesifite degerlerinin, %97 ve %96. ya yukseldigi tespit edildi. Sonuc olarak meme sintigrafisinin palpabl meme kitlelerinin tespitinde supheli mamogram ve ultrasonografiye sahip, meme kanseri acisindan yuksek risk tasiyan kadinlarda, lezyonun biyopsi oncesi malignite acisindan naturunu ortaya koymak amaciyla kullanimi onerilebilir. Anahtar kelimeler: Meme kanseri, Tc-99m MIBI meme sintigrafisi, mamografi, ultrasonografi. Abstract Comparison of Tc 99m MIBI scintomammography, mammography and ultrasonography in detection of breast carcinoma However breast carcinoma is the most common neoplasm found among women, improvements in diagnostic and therapeutic methods decreased the mortality rates. Although, mammography and ultrasonography are the most widely used methods for screening and diagnosing breast cancer; images of benign and malignant lesions can be similar in both methods and frequently result in negative biopsies. It is important to reduce the negative result ratios by using non-invasive diagnostic methods. For this purpose scintomammography and PET scanning methods by using different radionuclides can be perform. The aim of this study was to compare the specificity and sensitivity of mammography, ultrasonography and Technetium-99m- hexakis- 2-methoxy-isobutyl-isonitrile (Tc-99m MIBI) scintomammography methods in patients with palpable breast mass in detection of benign and malignant lesions retrospectively. A total 84 patients (mean age of 49.63±11.33 years) with palpable breast masses were studied. Mammography, ultrasonography and Tc-99m MIBI scintomammography were performed to all patients. Histopathological examination revealed malignancy in 30 patients and benign disease in 54 patients. In the detection of malignancy; sensitivity and specificity of scintomammography, mammography and ultrasonography were 93% and 91%, 83% and 85%, 87% and 89% respectively. Using a combination of three tests, the combined sensitivity and specificity was increased to 97% and 96%. In conclusion scintomammography might be a complementary method for suspicious lesions in mammography and ultrasonography in deciding which lesions require a biopsy. Key words: Breast cancer, Tc-99m MIBI scintomammography, mammography, ultrasonography.

Meme kanserinin tespitinde Tc-99m MIBI meme sintigrafisi, mamografi ve ultrasonografi yöntemlerinin etkinliklerinin karşılaştırılması