分化型甲状腺癌患者^131I治疗后体内残留放射性活度的评估  

Estimation of residual activities in patients with differentiated thyroid cancer after administration of ^131I for therapy

作　　者：汤敏敏[1] 刘建中[2] 武志芳[2] 陆克义[2] 李思进[2] 高永举[1] 武新宇[1] 徐俊玲[1] 

机构地区：[1]郑州大学人民医院(河南省人民医院)核医学科,450003 [2]山西医科大学第一医院核医学科,030001

出　　处：《国际放射医学核医学杂志》2014年第6期363-367,共5页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的 评估分化型甲状腺癌（DTC）患者^131I治疗后体内残留放射性活度.方法 本研究共纳入了35例DTC患者,分为“清甲”（20例）与“清灶”（15例）组,分别于服^13I后2、6、24、48、72 h进行^131I全身显像及1m处当量剂量率的测定,以2h时显像计数和活度作为总计数和总活度.根据各时间点显像计数与2h的显像计数比值间接估算体内残留放射性活度,并估算患者体内残留放射性活度达到400 MBq时的1m处当量剂量率.统计学分析采用直线相关与回归分析.结果 “清甲”组服^131I后2、6、24、48、72 h体内残留^131I活度占服^131I总活度的百分比分别为99％±4％、86％±6％、35％±10％、12％±8％、7％±8％, “清灶”组分别为99％±1％、91％±7％、47％±17％、11％±9％、4％±6％. “清甲”组服^131I后2、6、24、48、72 h的1m处当量剂量率分别为（157±37）、（120±36）、（35±13）、（11±9）、（9±11）μSv/h,“清灶”组分别为（234±43）、（186±51）、（49±20）、（12±11）、（4±6）μSv/h.体内残留的放射性活度与1m处当量剂量率呈正相关（r=0.87,P＜0.001）.“清甲”与“清灶”组服^131I后48、72 h体内残留放射性活度分别为（432±292）、（265±281） MBq及（731±701）、（277±470） MBq,对应的1m处当量剂量率为8～ 11 μSv/h.结论 DTC患者服^131I后48～72 h体内残留放射性活度达到国家标准规定的400 MBq时,即DTC患者1m处当量剂量率达到8～11 μSv/h时方可出院.Objective To estimate the residual activities of patients with differentiated thyroid cancer（DTC） after administration of ^131I for post-operative therapy.Methods Thirty-five DTC patients were divided into thyroid remnant ^131I ablation therapy group （20 cases）and ^131I treatment for metastatic lesions group （15 cases）.^131I whole body scan and the determination of equivalent dose rate at 1 meter point were performed to estimate multi-temporal residual activities in each patient 2,6,24,48,and 72 h after administration of therapeutic doses of ^131I,respectively.The percentage of residual activities was indirectly estimated in vivo through ratio of multi-temporal calculation of radioactive counts on ^131I whole body imaging versus that at 2 h（radioactive counts on ^131I whole body imaging and ^131I activity at 2 h were regarded as total counts and activities）,and furthermore the equivalent dose rate at 1 meter point was indirectly estimated when the residual activities reach to 400 MBq.Correlation and regression analysis were used to evaluate the relationship between residual activities and the equivalent dose rate at 1 m.Statistical significance was accepted at P〈0.05.Results The percentage of residual activities were 99%±4%,86%±6%,35%± 10%,12%±8%,7%±8% in thyroid remnant ^131I ablation therapy group,and 99%±1%,91%±7%,47%± 17%,11%±9% and 4%±6% in ^131I treatment for metastatic lesions group at 2,6,24,48 and 72 h after administration of ^131I,respectively.The equivalent dose rates at 1 m point were （157±37）,（120±36）,（35±13）,（11±9） and （9±11） μSv/h in thyroid remnant ^131I ablation therapy group and （234±43）,（186±51）,（49±20）,（12±11） and （4±6） μSv/h in ^131I treatment for metastatic lesions group at 2,6,24,48 and 72 h after administration of ^131I,respectively.There is a positive correlation between residual activities and equivalent dose rate at 1 m（r=0.87,P〈0.001）.The residual activities were（432±292）,（265± 281） MBq 48 a

关 键 词：甲状腺肿瘤 碘放射性同位素 体层摄影术 发射型计算机 单光子 

分 类 号：R736.1[医药卫生—肿瘤]