分化型甲状腺癌患者^131I治疗后诊断性全身显像周围剂量当量率动态变化的研究  

Study on the dynamic change in ambient dose equivalent rate in patients with differentiated thyroid carcinoma receiving diagnostic whole-body scan after ^131I therapy

作　　者：武含露 闫志华[1] 李祥周[1] 陈伟娜 贾静 崔丽萍 叶垚杉 刘阳[1] 韩星敏[1] 程兵[1] Wu Hanlu;Yan Zhihua;Li Xiangzhou;Chen Weina;Jia Jing;Cui Liping;Ye Yaoshan;Liu Yang;Han Xingmin;Cheng Bing(Department of Nuclear Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院核医学科,450052

出　　处：《国际放射医学核医学杂志》2020年第4期212-216,共5页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨分化型甲状腺癌(DTC)患者^131I治疗后6个月行诊断性全身显像(DxWBS)期间周围剂量当量率的动态变化。方法选取2018年8月至2019年1月于郑州大学第一附属医院核医学科接受^131I治疗的DTC患者85例,其中男性18例、女性67例,年龄(43.9±12.0)岁;≥55岁患者18例、<55岁患者67例。所有患者均空腹服用^131I 148 MBq(4 mCi),2 d后行Dx-WBS。治疗后效果为极好反应者,即^131I治疗后刺激状态下甲状腺球蛋白<1μg/L(甲状腺球蛋白抗体阴性)且影像学检查结果为阴性者(阴性组)48例,生化不全反应、结构不全反应及不确定性反应者(阳性组)37例。所有患者分别于服^131I后2、24、48 h时测定距体部1 m处的周围剂量当量率,对3个时间点的1 m处周围剂量当量率进行单因素重复测量方差分析,并采用t检验对不同性别、年龄及治疗效果组之间1 m处周围剂量当量率进行比较。结果(1)服^131I后2、24、48 h时距患者1 m处周围剂量当量率分别为(6.55±1.42)、(1.92±0.65)、(0.58±0.22)μSv/h,差异有统计学意义(F=807.30,P=0.000);距离患者1 m处周围剂量当量率随着时间的延长而下降。(2)不同性别组在服^131I后2、4、48 h时1 m处周围剂量当量率的差异均无统计学意义;年龄≥55岁组在24 h时1 m处周围剂量当量率高于年龄<55岁组(t=2.29,P=0.02),2 h和48 h时的差异均无统计学意义;阴性组和阳性组1 m处周围剂量当量率在各时间点的差异均无统计学意义。结论DTC患者^131I治疗后服诊断剂量^131I后48 h时1 m处周围剂量当量率均小于WS533-2017《临床核医学患者防护要求》规定的1.40μSv/h,达到国家规定的出门旅行要求,且不会对周围人群产生辐射损害。Objective To explore the dynamic change of the ambient dose equivalent rate during diagnostic whole-bady scan with differentiated thyroid carcinoma after ^131I therapy 6 months.Methods This study enrolled 85 patients aged(18 males and 67 females;43.9±12.0 years old)with DTC who received ^131I therapy in the Department of Nuclear Medicine of The First Affiliated Hospital of Zhengzhou University from August 2018 to January 2019.Among them,18 patients were≥55 years old and 67 patients were<55 years old.All patients were given 148 MBq(4 mCi)of ^131I on an empty stomach and received diagnostic whole-body scan 2 days later.The negative group(n=48)was defined as the excellent response.The patients in this group were administered with thyroid-stimulating hormone-stimulated thyroglobulin(<1μg/L)in the absence of structural or functional evidence of disease(and in the absence of anti-Tg antibodies).The positive group(n=37)was defined as the biochemically incomplete response,structurally incomplete response,and indeterminate response.Ambient dose equivalent rate was determined l m away from the patients at 2,24,and 48 h after ^131I administration.One-way repeated measures ANOVA was used on the three patient groups.T test was used to compare the ambient dose equivalent rate at 1 m between different groups of gender,age,and treatment effects.Results The range of ambient dose equivalent rate at 1 m at 2,24,and 48 h was(6.55±1.42),(1.92±0.65),and(0.58±0.22)μSv/h,respectively,indicating that ambient dose equivalent rate decreased over time.The differences were statistically significant(F=807.30,P=0.000).No statistically significant difference was found in ambient dose equivalent rate at 1 m after ^131I administration at any time in groups of different genders.The ambient dose equivalent rate at 1 m at 24 h was higher in the≥55 age group than in the<55 age group(t=2.29,P=0.02),and the other two time points were not statistically significant.No statistically significant difference was found between the negative group and

关 键 词：分化型甲状腺癌 碘放射性同位素 放射性核素显像 剂量当量率 辐射防护 

分 类 号：R736.1[医药卫生—肿瘤]