^(99m)Tc-MIBI SPECT/CT同机融合亲肿瘤显像辅助勾画肺癌放疗靶区及预测放疗疗效的临床价值研究  

Clinical Significance of ^(99m)Tc- MIBI SPECT/CT Imaging in Assisting Drawing Radiotherapy Target Volume and Predicting Efficacy of Lung Cancer

作　　者：张立广[1] 张力[1] 连相尧[1] 岳文慧[1] 王爱辉[2] 高东奇[1] 

机构地区：[1]承德医学院附属医院肿瘤科,河北省承德市067000 [2]承德医学院附属医院核医学科,河北省承德市067000

出　　处：《实用心脑肺血管病杂志》2014年第12期27-30,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：承德市科技支撑计划项目(20132045)

摘　　要：背景近年来,肺癌的发病率逐年升高,放疗是治疗肺癌的重要手段,如何精确界定放疗靶区及预测放疗疗效日益受到广大医师的重视。目的探讨99mTc-MIBI SPECT/CT同机融合亲肿瘤显像辅助勾画肺癌放疗靶区及预测放疗疗效的临床价值。方法选择2012年5月—2014年3月在承德医学院附属医院肿瘤科住院治疗的肺癌患者36例,在放疗前行99mTc-MIBI SPECT/CT同机融合亲肿瘤显像,并对所摄取比值行半定量分析,采用99mTc-MIBI SPECT/CT同机融合亲肿瘤显像辅助勾画肺癌放疗靶区。并根据患者放疗疗效将其分为有效组和无效组,并比较两组早期相肿瘤/正常肺组织摄取比值(EUR)、延迟相肿瘤/正常肺组织摄取比值(DUR)及滞留指数(RI)。结果 36例患者中13例(36.1%)修改了基于CT图像的靶区,其中10例(22.8%)明确区分了肺癌组织和肺不张、3例(8.3%)排除了纵隔淋巴结转移。有效组26例,EUR为(1.95±0.56)、DUR为(1.71±0.31),均高于无效组的(1.31±0.14)、(1.12±0.11)(P<0.05),两组RI比较〔(-4.19±2.01)比(-4.56±2.25)〕,差异无统计学意义(P>0.05)。结论99mTc-MIBI SPECT/CT同机融合亲肿瘤显像可以优化肺癌三维适形放疗靶区,在预测肺癌放疗疗效方面亦具有重要的临床价值。Background Lung cancer morbidity increases year by year, radiotherapy is the major therapy, and how to correctly draw the radiotherapy target volume and predict the efficacy becomes a hot topic in clinic. Objective To investigate the clinical significance of ^99mTc - MIBI SPECT/CT imaging in assisting drawing radiotherapy target volume and predicting efficacy of lung cancer. Methods A total of 36 lung cancer patients were selected in the Affiliated Hospital of Chengde Medical College from May 2012 to March 2014, all of them underwent ^99mTc - MIBI SPECT/CT imaging examination before radiotherapy, and then semiquantitative analysis was carried out on intake ratio of ^99mTc - MIBI, radiotherapy target volume was draw. According to the efficacy, all of the patients were divided into effective group （n =26） and ineffiecacy group （n = 10）, and they compared the EUR, DUR and RI between the two groups. Results Out of the 36 patients, 13 cases （36. 1% ） amended the radiothera- py target volume based on CT imaging, and thereinto 10 .cases （22. 8% ） defined the lung cancer tissue and atelectasis, 3 cases （8.3%） excluded mediastinal lymph node metastasis. Of effective group, EUR was （1.95 ± 0. 56）, DUR was （1.71 ± 0. 31 ）, was significantly higher than that of control group of （ 1.31 ± 0. 14）, （ 1.12 ± 0. 11 ）, respectively （P 〈 0. 05 ） ; no significant differences was found of RI between the two groups [ （ - 4. 19 ± 2.01 ） vs. （ - 4. 56 ± 2. 25 ）, P 〉0. 05 . Conclu- sion ^99mTc - MIBI SPECT/CT imaging can optimize the radiotherapy target volume of lung cancer, has certain clinic significance in predicting the radiotherapy efficacy of lung cancer.

关 键 词：肺肿瘤 ^99mTc—MIBI 正电子发射断层扫描及电脑断层扫描 放疗疗法 靶区 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]