分化型甲状腺癌转移灶碘代动力学及内照射吸收剂量的评估  

Evaluation of ^131I biokinetics and its absorbed dose in patients with metastatic differentiated thyroid carcinoma

作　　者：刘斌[1] 田蓉[1] 欧晓红[1] 黄蕤[1] 匡安仁[1] 

机构地区：[1]四川大学华西医院核医学科,成都610041

出　　处：《中华核医学与分子影像杂志》2016年第1期63-66,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金（81401445,81471692）

摘　　要：目的评估DTC转移灶的碘代动力学及^131I内照射吸收剂量。方法前瞻性分析2009年9月至2011年9月因DTC转移灶拟行^131I治疗的41例DTE患者。在患者服用3．70～9．25GBq^131I后采用连续显像法评估DTC病灶的碘代动力学，利用CT计算病灶的质量，按照美国核医学与分子影像学会医用内照射剂量学委员会提出的内照射吸收剂量的计算方法，计算DTC病灶的吸收剂量。采用Kruskal．Wallis秩和检验比较不同部位DTC病灶吸收剂量间的差异。结果41例DTC患者共有59个亲碘性转移灶（分布在颈淋巴结、肺及骨的转移灶数量分别为35、17和7个），其^131I吸收剂量在0．1～136．2Gy／GBq，均值（10．4±6．5）Gy/GBq。颈淋巴结、肺及骨转移灶的吸收剂量中位值分别为11．3、10．1及9．6Cy／GBq，不同部位病灶吸收剂量的差异无统计学意义（Z=0．907，P〉0．05）。结论^131I治疗DTC转移灶，病灶间的吸收剂量差异较大。Objective To investigate the biokinetics of ^131I and its absorbed dose in patients with metastatic DTC. Methods Forty-one patients with metastatic DTC who were referred to ^131I therapy were prospectively recruited from September 2009 to September 2011. Scintigraphic images were serially acquired after the ingestion of ^131I（3.70-9.25 GBq） to assess the biokinetics. CT was used to measure the masses of the DTC lesions. Calculation of absorbed doses to DTC lesions was based on the Medical Internal Radiation Dosimetry formula of the Society of Nuclear Medicine and Molecular Imaging. Kruskal-Wallis rank sum test was used to compare the differences of absorbed dose among different tumor deposits. Results In total, 59 iodine-avid metastatic lesions （35 in cervical lymph node, 17 in lung and 7 in bone） in 41 patients were evaluated and the mean absorbed dose of DTC lesions was （10.4±6.5） Gy/GBq, with range of 0.1 to 136.2 Gy/GBq. The median absorbed dose was 11.3 Gy/GBq for lymph node metastase, 10.1 Gy/GBq for lung metastases and 9.6 Gy/GBq for bone metastases. There were no statistically significant differences in absorbed doses a- mong the metastases of lymph node, lung and bone （Z= 0.907, P〉0.05）. Conclusion A wide inter-lesion variation of absorbed dose to metastatic DTC is observed.

关 键 词：甲状腺肿瘤 肿瘤转移 放射疗法 碘放射性同位素 辐射剂量 

分 类 号：R736.1[医药卫生—肿瘤]