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SUV是PET/CT中最为常用的半定量指标,已经被广泛用于肿瘤良恶性的鉴别诊断、疗效的评价及预后评估,但其受到的影响因素有很多,包括采集时间间隔、血糖浓度和胰岛素水平以及药物剂量[1]。其中18F-FDG药物的注射活度就关系到临床的半定量指标分析,用于计算SUV。本研究旨在研究残留活度的影响因素,从而实现药物分装的规范化操作。
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注射后注射器针筒、注射器针头、三通及头皮静脉针残留的放射性活度减去空气中的放射性本底后的中位数(四分位距)分别为1.59(0.93)、3.35(3.43)、1.70(0.92)MBq,总残留放射性活度为7.09(4.31)MBq。总残留活度最小值为1.59 MBq,最大值为20.68 MBq。注射18F-FDG的100例患者的注射材料不同部位的放射性残留活度见表 1。
统计结果 残留活度/MBq 总的 针筒 针头针帽 三通及头皮静脉针 均值 7.54 1.71 4.04 1.80 中位数 7.09 1.59 3.35 1.70 方差 12.37 0.62 8.21 0.57 标准差 3.52 0.79 2.87 0.75 最小值 1.59 0.44 0.33 0.48 最大值 20.68 3.74 13.51 4.00 截距 19.09 3.30 13.18 3.52 四分位距 4.31 0.93 3.43 0.92 表 1 注射18F-FDG的100例患者的注射材料不同部位的残留放射性活度的统计值
Table 1. Radioactive residual activity statistics of 100 patients with 18F-FDG PET/CT examination
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注射药物的活度与体积的比值为注射药物的放射性浓度。由表 2可见,18F-FDG注射药物的放射性活度与总残留放射性活度无相关性(r=0.099,P>0.05);18F-FDG注射药物的体积与总残留放射性活度呈负相关(r=-0.605,P<0.01),这表明18F-FDG注射药物的体积越大,总残留放射性活度越小;18F-FDG注射药物的放射性浓度与总残留放射性活度呈正相关(r=0.594,P<0.01),这表明总残留放射性活度随18F-FDG注射药物放射性浓度的增大而增大。
残留活度 相关性 注射药物活度 注射药物体积 注射药物浓度 总的 r=0.099,
P=0.328r=-0.605,
P=0.000r=0.594,
P=0.000针筒 r=0.027,
P=0.788r=-0.661,
P=0.000r=0.633,
P=0.000针头针帽 r=0.061,
P=0.550r=-0.312,
P=0.002r=0.298,
P=0.003三通及头皮经脉 r=0.279,
P=0.005r=-0.682,
P=0.000r=0.747,
P=0.000表 2 100例行18F-FDG PET/CT检查的患者注射18F-FDG材料的不同部位的残留放射性活度与相关参数的Spearman相关性分析
Table 2. Spearman correlation analysis of radioactivity residue activity and related parameters in 100 patients with 18F-FDG PET/CT examination
对20组数据取平均值,以注射药物放射性浓度为自变量,总残留放射性活度为因变量做曲线拟合(图 1)。根据图 1显示结果,把注射药物放射性浓度分为3组,分段进行相关性分析。当18F-FDG注射药物的放射性浓度>600 MBq/mL时,总残留放射性活度随18F-FDG注射药物放射性浓度的增大而增大(r=0.684,P < 0.01);当浓度 < 400 MBq/mL时,注射药物体积的增加和注射时间增长,增加了操作人员的受照时间(r=0.420,P < 0.01);当浓度介于400~600 MBq/mL之间时,总残留放射性活度与18F-FDG注射药物放射性浓度无相关性(r=0.181,P>0.05)。
18F-FDG注射残留放射性活度影响因素的分析
Analysis of factors affecting the residual radioactive activity of injection of 18F-FDG
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摘要:
目的分析18F-FDG药物注射过程中影响其注射后残留放射性活度的因素,以指导临床放射性药物的分装。 方法收集2017年10月至12月在首都医科大学附属北京世纪坛医院核医学科行PET/CT检查的患者100例,按其注射药物的体积和放射性活度分组,用放射性活度计记录注射后注射器针筒、注射器针头、三通及头皮针残留的放射性活度以及空气中的放射性本底,并对总残留放射性活度和注射药物的放射性浓度进行曲线拟合。采用SPSS 17.0统计学软件进行正态分布检验及Spearman相关性分析。 结果注射后注射器针筒、注射器针头、三通及头皮静脉针残留的放射性活度的中位数(四分位距)分别为1.59(0.93)、3.35(3.43)、1.70(0.92)MBq,总残留放射性活度为7.09(4.31)MBq;总残留放射性活度与18F-FDG注射药物的放射性浓度呈正相关(r=0.594,P < 0.01),对其进行曲线拟合,放射性浓度 < 600 MBq/mL为宜。 结论对18F-FDG浓度进行稀释,降低其放射性浓度能减少总残留放射性活度,精确注射药物活度,同时能够降低对工作人员的受照剂量。 Abstract:ObjectiveThe factors influencing residual radioactivity in 18F-FDG injection were analyzed to guide the packing of radiopharmaceuticals. MethodsA total of 100 patients subjected to 18F-FDG PET/CT in Beijing Shijitan Hospital from October 2017 to December 2017 were analyzed. Patients were divided into different groups based on the volume and radioactivity of the radiopharmaceuticals they received. The residual radioactivity of the syringe tube, syringe needle, three-way valve, scalp needle, and background was then measured separately using a radioactivity meter. The curve of the total residual radioactivity as a function of 18F-FDG concentration was then fitted. SPSS 17.0 statistical software was used to test the normality of the data distribution, and results were analyzed by Spearman correlation. ResultsThe residual radioactivity values of the syringe needle tube, syringe needle, three-way valve, and scalp intravenous needle were 1.59(0.93), 3.35(3.43), and 1.70(0.92) MBq, respectively. The total residual radioactivity was 7.09(4.31 MBq) and significantly related to the concentration of 18F-FDG applied(r=0.594, P < 0.01). According to the fitting curve obtained, the appropriate radioactivity concentration of 18F-FDG is less than 600 MBq/mL. ConclusionsIn clinical work, appropriate dilution of the 18F-FDG injection volume and decreasing the radioactivity of pharmaceuticals can effectively reduce the total residual radioactivity of the procedure. Medical institutions should measure the appropriate dilution concentration of radioactive drugs according to the specifications of the syringes to increase the precision of injection and reduce the irradiation dose of the staff. -
Key words:
- Fluorodeoxyglucose F18 /
- Radioactivity /
- Drug residues
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表 1 注射18F-FDG的100例患者的注射材料不同部位的残留放射性活度的统计值
Table 1. Radioactive residual activity statistics of 100 patients with 18F-FDG PET/CT examination
统计结果 残留活度/MBq 总的 针筒 针头针帽 三通及头皮静脉针 均值 7.54 1.71 4.04 1.80 中位数 7.09 1.59 3.35 1.70 方差 12.37 0.62 8.21 0.57 标准差 3.52 0.79 2.87 0.75 最小值 1.59 0.44 0.33 0.48 最大值 20.68 3.74 13.51 4.00 截距 19.09 3.30 13.18 3.52 四分位距 4.31 0.93 3.43 0.92 表 2 100例行18F-FDG PET/CT检查的患者注射18F-FDG材料的不同部位的残留放射性活度与相关参数的Spearman相关性分析
Table 2. Spearman correlation analysis of radioactivity residue activity and related parameters in 100 patients with 18F-FDG PET/CT examination
残留活度 相关性 注射药物活度 注射药物体积 注射药物浓度 总的 r=0.099,
P=0.328r=-0.605,
P=0.000r=0.594,
P=0.000针筒 r=0.027,
P=0.788r=-0.661,
P=0.000r=0.633,
P=0.000针头针帽 r=0.061,
P=0.550r=-0.312,
P=0.002r=0.298,
P=0.003三通及头皮经脉 r=0.279,
P=0.005r=-0.682,
P=0.000r=0.747,
P=0.000 -
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