Images of estrogen-receptor-positive breast tumors produced by estradiol labeled with iodine I 123 at 16 alpha
D. E. Kenady, E. J. Pavlik, K. Nelson, J. R. van Nagell, H. Gallion, P. D. DePriest, U. Y. Ryo and R. J. Baranczuk
Department of Surgery, University of Kentucky College of Medicine, Lexington.
OBJECTIVE: To examine the suitability of estradiol labeled with iodine I
123 at 16 alpha for imaging estrogen-receptor-positive breast carcinoma
using imaging instrumentation that is widely available. DESIGN:
Single-photon emission computed tomographic imaging survey of 29 women with
suspected primary or expected recurrent breast carcinoma. SETTING:
University-based referral center. PARTICIPANTS: Twenty-nine women
undergoing diagnosis for primary or recurrent breast carcinoma. Selection
was voluntary. MAIN OUTCOME MEASURE: Qualitative imaging study designed to
provide tomographic data of radioligand retention and descriptive data of
imaging results. RESULTS: Single-photon emission computed tomographic
imaging using 123I-estradiol at 16 alpha was performed for patients with
breast carcinoma. Independent readers, without knowledge of receptor status
or proven disease, interpreted the films. Scintigraphic detection was most
noteworthy in patients with chest wall tumors and inflammatory breast
cancer. Agreement between readers was 98% for true-negative readings and
94% for true-positive readings, but only 60% for false-positive and
false-negative film readings. CONCLUSIONS: Our results indicated that areas
shown on imaging were also found to have estrogen-receptor activity and
that radioligand accumulation can occur with low frequency in some
surgically explored tissue. Radioligand imaging with 16
alpha-123I-estradiol can locate estrogen-receptor-positive breast tumors,
including some that may be difficult to detect using conventional
diagnostic imaging.
