分化型甲状腺癌不同部位转移灶^(131)I-SPECT/CT影像学数据分析  

^(131)I-SPECT/CT imaging data analysis of different metastatic sites of differentiated thyroid cancer

作　　者：吴震宇[1] 王辉[1] 

机构地区：[1]上海交通大学医学院附属新华医院核医学科,上海200092

出　　处：《上海交通大学学报（医学版）》2011年第8期1154-1158,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市重点学科建设项目(S30203)~~

摘　　要：目的分析分化型甲状腺癌(DTC)不同部位转移灶行131I治疗后48 h的131I-SPECT/CT显像数据,为131I治疗DTC剂量的制定提供依据。方法对20例共53处DTC转移灶行131I治疗后48 h行SPECT/CT显像,利用软件计算转移灶体积、肿瘤/非肿瘤比值、摄碘率、单位体积活度和病灶密度(CT值)等相关数据,分析不同转移部位的数据特点及其与转移灶治疗效率的相关性。结果①骨转移灶单位体积的131I摄取量低于其他部位转移,为(1.01±1.23)MBq/cm3,且疗效最差;②影响疗效最主要的因素是病灶的体积,软组织、肺和淋巴结病灶的体积越小,则治疗效果越好(r=-0.932,P=0.021;r=-0.897,P=0.000;r=-0.966,P=0.000),而骨转移灶体积与疗效的相关性不显著(r=-0.469,P=0.078);③病灶部位CT扫描未发现局部破坏或结节形成,则治疗效果最好,均可一次清除病灶。结论不同部位DTC转移灶的摄碘能力不同,导致了治疗效果的差异;治疗前应测定各转移病灶的影像学数据,制定个体化制定治疗方案。Objective To analyse and compare the imaging data of 131I-SPECT/CT of different metastatic sites of differentiated thyroid carcinoma(DTC) 48 h after 131I therapy,and provide evidences for the dosimetry of 131I therapy for DTC. Methods Forty-eight hours after 131I intake,SPECT/CT imaging was performed on 20 patients with 53 metastatic sites.The data of size of metastatic lesions,tumor/non-tumor ratio,iodine uptake rate,radioactivity per unit volume and lesion density(CT value) were calculated with software.The features of data of different metastatic sites were analysed,and correlation analysis was conducted between these data and treatment efficiency of metastatic lesions. Results ①131I uptake per unit volume of bone metastases was significantly lower than the other metastatic sites [(1.01±1.23) MBq/cm3;P=0.029,0.463,0.003,respectively],and the efficacy was the worst.②The most important factor influencing treatment efficacy was size of lesions.The smaller the soft tissue,lung and lymph node lesions were,the better the treatment efficacy was(r=-0.932,P=0.021;r=-0.897,P=0.000;r=-0.966,P=0.000).While the correlation between size of bone metastatic lesions and treatment efficacy was not significant(r=-0.469,P=0.078).③When no local damage or nodule in lesion sites was found with CT scan,the treatment was most efficient,and the lesions could be totally removed after one therapy. Conclusion Different sites of metastatic lesions of DTC have different iodine uptake capacity,which leads to significant differences in treatment efficiency.Imaging data analysis of each metastatic site should be conducted before treatment to design individualized regimens.

关 键 词：分化型甲状腺癌 SPECT/CT 转移 剂量学 

分 类 号：R736.1[医药卫生—肿瘤]