99Tcm-甲氧基异丁基异腈SPECT评价非小细胞肺癌化疗疗效
99Tcm-methoxyisobutylisonitrile SPECT imaging evaluate chemotherapy of non-small cell lung cancer
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摘要: 目的 探讨99Tcm-氧基异丁基异腈(99Tcm-MIBI)SPECT评估非小细胞肺癌(NSCLC)化疗疗效的价值。方法 71例NSCLC患者根据胸部CT分为化疗有效组(完全缓解+部分缓解)和无效组(病情稳定+疾病进展),于化疗前行99Tcm-MIBI SPECT,静脉注射99Tcm-MIBI 740 MBq后10~30 min及2~3 h分别行早期及延迟显像,在99Tcm-MIBI显像图上用感兴趣区(ROI)的方法勾画出病灶,然后选取镜像ROI于健侧肺的相应部位,由此分别获得早期相肿瘤,正常肺组织摄取比值(ER)和延迟相肿瘤/正常肺摄取比值(DR),并计算滞留指数(RI)。采用t检验及秩和检验分析化疗有效组与化疗无效组ER、DR和RI之间的差别。结果 99Tcm-MIBI显像结果中,化疗有效组的ER、DR分别为2.39±0.21、2.50±0.19,均显著高于化疗无效组的1.89±0.19、2.05±0.21,统计学差异有意义(t=8.311、8.480,P<0.05)。化疗有效组的RI中位值为6.63%,高于化疗无效组的5.13%,统计学差异有意义(Z=2.416,P<0.05)。结论 99Tcm-MIBI显像在评估NSCLC化疗疗效方面具有重要的临床价值。
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关键词:
- 癌,非小细胞肺 /
- 99m锝-甲氧基异丁基异腈 /
- 体层摄影术,发射型计算机,单光子 /
- 药物疗法
Abstract: Objective To discuss 99Tcm-methoxyisobutylisonitrile(99Tcm-MIBI)imaging evaluation of the value of chemotherapy in patients with non-small cell lung cancer(NSCLC).Methods Seventy-one patients with NSCLC were studied with 99Tcm-MIBI SPECT before chemotherapy.The patients were classified by a follow-up CT as good responders(complete or partial remission)and poor respenders(stable disease or progressive disease).Following injection vein administration of 740MBq 99Tcm-MIBI,SPECT imaging at 10-30 min(early)and 2-3 h(delayed)were performed.Regions of interests were placed over the tumors and contralateral normal tissue on one transverse section.The 99Tcm-MIBI uptake ratio of the lesion to that in the contralateral normal lung was obtained from early images(ER)as well as delayed images(DR).The retention index(RI)was measured as:RI=(DR-ER)/ER×100%. 99Tcm-MIBI tumor uptake parameters were compared with the chemotherapeutic response.Results 99Tcm-MIBI uptake was significantly higher in responders than in non-responders:2.39±0.21 vs 1.89±0.19 and 2.50±0.19 vs 2.05±0.21 for ER and DR,respectively(t=8.311,8.480,P<0.05).The median of RI in good response group was significantly higher than that in poor response group(6.63% vs 5.13%,Z=2.416,P<0.05).Conclusion ER,DR and RI of 99Tcm-MIBI SPECT may benefit to evaluating chemotherapy response NSCLC. -
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