^(99)Tc^m-MIBI融合显像辅助肺癌放疗靶区定位及对化疗疗效的预测  

^(99)Tc^m-methoxyisobutylisonitrile SPECT/CT fusion imaging in assisting radiotherapy target positioning and predicting chemotherapy efficacy of lung cancer

作　　者：杨雅娜[1,2] 罗焱[1] 胡义德[3] 张明慧[3] 张青[1] 

机构地区：[1]第三军医大学新桥医院核医学科,重庆400037 [2]重庆医科大学附属第一医院金山医院体检中心,重庆400016 [3]第三军医大学新桥医院肿瘤科,重庆400037

出　　处：《第三军医大学学报》2012年第10期991-994,共4页Journal of Third Military Medical University

摘　　要：目的探讨99Tcm-MIBI SPECT/CT同机融合显像辅助肺癌放疗靶区定位的价值,分析肿瘤组织摄取99Tcm-MIBI与化疗疗效之间的关系。方法回顾性分析经病理确诊的19例非小细胞肺癌患者,放、化疗前均行99Tcm-MIBISPECT/CT显像,通过感兴趣区技术勾画肿瘤靶区并确定计划靶区;获取感兴趣区放射性计数,计算肿瘤早期摄取比(T/NTe)、延迟摄取比(T/NTd)及肿瘤组织滞留率(RI%),分析T/NTe、T/NTd、RI%与患者临床分期及病理类型的关系。结果 19例患者中99Tcm-MIBI显像阳性18例,修改CT计划靶区15例,占78.9%;明确区分肺不张与肿瘤病灶11例,占57.9%。化疗有效患者T/NTe、T/NTd比值分别为(2.47±0.23)、(2.35±0.19),无效患者分别为(1.72±0.10)、(1.63±0.12),两者差异统计学有意义(P<0.01),两者RI%比较差异无统计学有意义(P>0.05),T/NTe、T/NTd、RI%在不同临床分期、病理类型中差异均无统计学有意义(P>0.05)。结论99Tcm-MIBI SPECT/CT融合显像有助于优化肺癌立体放疗靶区,选取T/NTe=2.0作为预测化疗有效的阈值有较高的准确性,且不受患者临床分期及病理类型的影响。Objective To investigate the value of 99Tcm-methoxyisobutylisonitrile（99Tcm-MIBI） SPECT/CT fusion imaging in assisting radiotherapy target positioning of lung cancer,and to analyze the relationship between the rate of 99Tcm-MIBI uptake and chemotherapy efficacy in lung cancer.Methods In a retrospective study,99Tcm-MIBI SPECT/CT were performed in 19 patients with non-small-cell lung cancer（NSCLC） within one week before radiotherapy and chemotherapy.The gross tumor volume was obtained by the region of interest（ROI） technique,and the planning target volume（PTV） was also identified.The radioactive counts of ROI were analyzed and early target/normal（T/NTe）,delayed target/normal（T/NTd） and retention index（RI%） were calculated.The association of T/NTe,T/NTd and RI% with patients＇ clinical stage and pathological type was analyzed.Results Among all the 19 NSCLC patients who underwent 99Tcm-MIBI SPECT/CT,18 patients were positive.The PTVs of 15 patients obtained from CT were modified according to SPECT/CT,accounting for 78.9%.Of the 15 patients with modified PTVs,the tissues of atelectasis and tumor were clearly identified in 11 patients,accounting for 57.9%.The mean values of T/NTe and T/NTd of the good-response patients（2.47±0.23 and 2.35±0.19） were significantly higher than those of the poor-response patients（1.72±0.10 and 1.63±0.12,P0.01）,while RI% showed no significant difference between the two groups（P0.05）.There were no significant differences of T/NTe,T/NTd and RI% among the patients with different clinical stages and pathological types（P0.05）.Conclusion 99Tcm-MIBI SPECT/CT fusion imaging is helpful to optimize radiotherapy target.Using T/NTe 2.0 as the threshold for assessing chemotherapy efficacy has high accuracy,and can avoid the interference from patients＇ clinical stage and pathological type.

关 键 词：肺癌 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 甲氧基异丁基异腈 

分 类 号：R730.53[医药卫生—肿瘤] R814.3[医药卫生—临床医学]