Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Diagnostic value of 99m Tc-bombesin scintigraphy for differentiation of malignant from benign breast lesions Farzaneh Shariati a , Kamran Aryana a , Asiehsadat Fattahi b , Mohammad N. Forghani b , Azita Azarian c , Seyed R. Zakavi a , Ramin Sadeghi a , Narjes Ayati a and Keyvan Sadri a Objective In this study, we evaluated the diagnostic accuracy of 99m Tc-bombesin scintigraphy for differentiation of benign from malignant palpable breast lesions. 99m Tc-Bombesin is a tracer with high affinity for gastrin- releasing peptide receptor, which is overexpressed on a variety of human tumors including breast carcinoma. Materials and methods We examined 33 consecutive women who were referred to our center with suspicious palpable breast lesions but had no definitive diagnosis in other imaging procedures. A volume of 370–444 MBq of 99m Tc-bombesin was injected and dynamic 1-min images were taken for 20 min immediately after injection in anterior view. Thereafter, two static images in anterior and prone- lateral views were taken for 5 min. Finally, single-photon emission computed tomography images were taken for each patient. Definitive diagnosis was based on biopsy and histopathological evaluation. Results The scan findings were positive in 19 patients and negative in 11 on visual assessment of the planar and single-photon emission computed tomography images. Pathologic examination confirmed breast carcinoma in 12 patients with positive scans and benign pathology for 18 patients. The overall sensitivity, specificity, negative and positive predictive values, and accuracy of this radiotracer for diagnosis of breast cancer were 100, 66.1, 100, 63, and 76%, respectively. Semiquantitative analysis improved the specificity of the visual assessment from 66 to 84%. Conclusion Our study showed that 99m Tc-bombesin scintigraphy has a high sensitivity and negative predictive value for detecting malignant breast lesions, but the specificity and positive predictive value of this radiotracer for differentiation of malignant breast abnormalities from benign ones are relatively low. Nucl Med Commun 00:000–000  c 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Nuclear Medicine Communications 2014, 00:000–000 Keywords: benign, breast cancer, malignant, single-photon emission computed tomography, 99m Tc-bombesin scintigraphy a Nuclear Medicine Research Center, b Minimally Invasive and Endoscopic Surgery Research Center and c Department of Radiology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Correspondence to Kamran Aryana, MD, Nuclear Medicine Research Center, Ghaem Hospital, Ahmad Abad St, Mashhad 99199-91766, Iran Tel: + 98 511 801 2781; fax: + 98 511 893 3186; e-mail: kamaryana@yahoo.com Received 15 November 2013 Revised 7 February 2014 Accepted 25 February 2014 Introduction Breast cancer is the most common malignancy in women worldwide. Approximately, 230 000 new cases of breast cancer are diagnosed every year in the USA alone, which result in more than 39000 deaths yearly. The incidence rate is estimated at 12% of all women and it has been increasing recently [1]. Therefore, early detection of malignant breast lesions is necessary for proper management and treatment, which in turn results in a better and more favorable patient outcome [2]. Routine diagnostic tools for evaluation of breast lesions include physical examination, mammography, and ultrasono- graphy. If the results of these procedures are equivocal and indeterminate, depending on the clinician’s opinion, other noninvasive imaging procedures such as MRI, mammoscinti- graphy, and positron emission mammography can be used [3,4]. In mammoscintigraphy, different radiopharmaceuticals including 201 Tl, 99m Tc-sestamibi, 99m Tc-tetrofosmin, 99m Tc-thymine, and 99m Tc-bombesin are used [5–10]. Bombesin is a gastrin-releasing peptide receptor analogue that is overexpressed on several human tumors including lung, prostate, ovarian, colon, stomach, exocrine pancrea- tic, and breast. This peptide acts as a mitogen, morphogen, growth, and antiapoptotic factor and also as a neurotransmitter in both normal and tumoral cells [11–18]. Bombesin-like peptides can be labeled with g ray- emitting radioisotopes and also with b emitter radionuclides for cancer imaging and treatment goals, respectively [19]. The main aim of this study was to evaluate the diagnostic value of 99m Tc-labeled bombesin scintigraphy in differ- entiation of benign from malignant breast lesions. Materials and methods Thirty-three consecutive female patients, who were between 17 and 65 years of age with an average of 40±12 years, with a suspected breast lesion on mammo- graphy (BIRAD category III or IV) or with an inconclusive sonography report between October 2012 and August Original article 0143-3636  c 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins DOI: 10.1097/MNM.0000000000000112