^(99m)Tc-HL91 SPECT/CT对鼻咽癌原发灶乏氧检测的可行性研究  

Feasibility of ^(99m)Tc-HL91 SPECT/CT for imaging hypoxia in nasopharyngeal carcinoma

作　　者：郑颖洁[1] 赵充[2] 樊卫[2] 刘慧[2] 崔念基[2] 陈福进[2] 

机构地区：[1]首都医科大学附属北京朝阳医院,北京100020 [2]华南肿瘤学国家重点实验室中山大学肿瘤防治中心,广东广州510060

出　　处：《中华肿瘤防治杂志》2007年第1期44-47,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：广东省社会发展领域科技计划(粤科社字[2003]245号)

摘　　要：目的:探讨99mTc-HL91 SPECT/CT用于鼻咽癌原发灶乏氧临床研究的可行性。方法:选择初治鼻咽癌患者22例,静脉注射99mTc-HL91 25mCi(925 MBq),对前5例患者分别于0.5、2、4、6h进行断层显像,观察99mTc-HL91在鼻咽的生物分布,分析各时间点的图像,确定最佳显像时间;再于所确定的最佳显像时段对另17例患者进行断层扫描,分析显像图像。目测分析以肉眼可辨别的鼻咽病灶区放射性浓聚高于正常鼻咽本底为乏氧显像阳性;再对阳性病例进行半定量分析,通过核医学感兴趣区技术分别计算鼻咽病灶内放射性浓聚部位(T+)、病灶内非放射性浓聚部位(T-)及正常鼻咽组织(N)的放射性计数比(T+/N和T-/N)。结果:5例鼻咽癌患者鼻咽病灶浓聚部位(T+)和正常鼻咽组织(N)对99mTc-HL91的摄取均在0.5h最高,然后逐渐下降,且随时间延迟,T+/N比值逐渐升高,至4h时T+/N比值最高;22例患者中,目测分析阳性20例(90.91%),阳性病例中T+/N为1.64±0.38,T-/N为1.09±0.17,两者差异有统计学意义,P<0.05。结论:99mTc-HL91 SPECT/CT显像图像能够较好地辨别鼻咽病灶内浓聚和非浓聚区域,是临床上用于评价鼻咽癌乏氧状况的可行手段。OBJECTIVE：To explore the feasibility of hypoxic imaging in nasopharyngeal carcinoma （NPC） with ^99m Tc-HL91 SPECT/CT. METHODS： Twenty-tow primary NPC patients admitted, ^99m Tc-HL91 25mCi （925 MBq） was intravenous injected, SPECT/CT scans were performed at 0.5, 2,4, 6 h after injection in the first 5 patients. The uptake of ^99m Tc-HL91 in tumor and normal tissues of nasopharynx （NP） on different check points were observed, and the changes of T^＋/N were analyzed in order to find the best time to image. Then at the best imaging time, scans were carried out in other 17 patients. Visual analysis positive was that NP lesion radioactivity was higher than the normal NP tissue background （N）. Then for positive cases, semi-quantitative analysis were processed. The high density region （T^＋ ）, the low density region （T^-） in the same one NP lesion and the normal tissues （N） of NP were delineated with the technique of region of interesting （ROI）, Then T^＋/N ratio and T^-/N ratio were measured respectively. RESULTS： For the first 5 patients, the uptake of ^99m Tc-HL91 in high density region（T^＋） and normal tissue（N） of NP were the highest in the images taken on 0.5 hr after injection, and then decreased gradually. Along with the delay of time, T^＋/N increased gradually, till 4 hr it came to a peak value. For all patients, 20 of 22 NPC （90.91%） were positive imaging, the T^＋/N ratio was significantly higher than the T^-/N ratio （1.64 ± 0. 38 vs 1.09±0. 17,P〈0.05）. CONCLUSION：The images of ^99m Tc-HL91 SPECT/CT can help to distinguish the high density and low density regions in nasopharyngeal lesion, and it is a feasible modality to evaluate the hypoxia status of NPC.

关 键 词：^99MTC-HL91 鼻咽肿瘤 乏氧显像 

分 类 号：R739.63[医药卫生—肿瘤]