99mTc-HYNIC-TOC人体内照射剂量研究  

A study on the dose of 99mTc-HYNIC-TOC in humans

作　　者：卢麟俊 许晓平[1,2,3] 徐俊彦 张建岗[1,4] 章英剑 宋少莉[1,2,3,4] 张建平 LU Linjun;XU Xiaoping;XU Junyan;ZHANG Jiangang;ZHANG Yingjian;SONG Shaoli;ZHANG Jianping(Department of Nuclear Medicine,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Center for Biomedical Imaging,Fudan University,Shanghai 200032,China;Shanghai Engineering Research Center of Molecular Imaging Probes,Shanghai 200032,China;Department of Nuclear Medicine,Shanghai Proton and Heavy Ion Center,Shanghai 201321,China;Key Laboratory of Nuclear Physics and Ion-Beam Application,Institute of Modern Physics,Fudan University,Shanghai 200433,China)

机构地区：[1]复旦大学附属肿瘤医院核医学科,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学生物医学影像研究中心,上海200032 [3]上海分子影像探针工程技术研究中心,上海200032 [4]上海市质子重离子医院核医学科,上海201321 [5]复旦大学核物理与离子束应用教育部重点实验室,上海200433

出　　处：《中国癌症杂志》2020年第11期872-878,共7页China Oncology

基　　金：上海市卫健委面上项目(201740185);上海分子影像探针工程技术研究中心项目(19DZ2282200);国家自然科学基金(81771861,81971648);上海市科技创新计划(18410711200,19142202100);国家重点研发计划(2019YFC1604605)。

摘　　要：背景与目的:放射性显像药物在人体内的剂量分布、各器官的吸收剂量及全身有效剂量数据非常重要。研究99mTc标记的经肼基烟酰胺修饰的奥曲肽(99mTc-Hydrazinonicotinyl-Tyr3-Octreotide,99mTc-HYNIC-TOC)在人体内各器官的吸收剂量、全身吸收剂量及全身有效剂量。方法:对2018年5—6月复旦大学附属肿瘤医院收治的5例神经内分泌肿瘤患者静脉注射370 MBq 99mTc-HYNIC-TOC后于0.5、1.0、2.0、4.0和8.0 h行全身平面采集,其中2.0 h平面采集后即刻行全身断层采集。断层数据经迭代重建后,将数据导入GE Dosimetry Toolkit处理,在单光子发射计算机断层显像(single photon emission computed tomography,SPECT)/CT融合图像上勾画各器官生成感兴趣区(region of interest,ROI),获得相应时间-活度曲线并计算曲线下面积得到滞留时间。依据美国核医学会医用内照射剂量学(Medical Internal Radiation Dose,MIRD)委员会提出的内照射剂量计算方法(MIRD体系),利用OLINDA/EXM软件计算99mTc-HYNIC-TOC在人体内各器官的吸收剂量、全身吸收剂量和全身有效剂量。结果:脾脏、膀胱、肾脏的单位活度吸收剂量较高,男性分别为0.042、0.019和0.016 mGy/MBq,女性分别为0.026、0.027和0.017 mGy/MBq。大脑、皮肤、甲状腺的单位活度吸收剂量较低,男性分别为0.0003、0.0005和0.0005 mGy/MBq,女性分别为0.0003、0.0005和0.0006 mGy/MBq。对放射线敏感的器官如骨原细胞、胸腺和红骨髓的单位活度吸收剂量均较低,范围为0.0012~0.0022 mGy/MBq。全身平均单位活度吸收剂量男性为0.0017 mGy/MBq,女性为0.0016 mGy/MBq。全身单位活度有效剂量男性为0.00458 mSv/MBq,女性为0.00455 mSv/MBq。结论:99mTc-HYNIC-TOC可安全地用于人体,其有效剂量低于允许范围上限。该研究结果可为临床安全使用99mTc-HYNIC-TOC提供依据,也为其他放射性药物的安全性评估和加快临床转化提供新的可行方案。Background and purpose:The data of radioactive imaging drug dose distribution in human body,absorbed dose of organs and effective dose of whole body are very important.The purpose of this study was to estimate the absorbed doses of different organs and the effective dose from the biodistribution of the 99mTc-hydrazinonicotinyl-Tyr3-octreotide(99mTc-HYNIC-TOC)in humans with hybrid single photon emission computed tomography(SPECT)imaging.Methods:Whole body planar imaging was acquired at 0.5,1.0,2.0,4.0 and 8.0 h after administration of 370 MBq 99mTc-HYNIC-TOC to 5 patients with neuroendocrine tumors who were treated in Fudan University Shanghai Cancer Center from May to Jun.2018,and the tomography of the whole body was achieved at 2.0 h.After iterative reconstruction,the data were imported into GE Dosimetry Toolkit.Region of interest(ROI)of different organs was delineated in SPECT/CT images,and the residence time equal to the area under the curve was calculated by time-activity curve.The absorbed doses of different organs and the whole body and the effective dose of whole body were calculated by OLINDA/EXM software according to the standard methods which were developed by Medical Internal Radiation Dose(MIRD)Committee.Results:The absorbed dose coefficients of spleen,bladder and kidney(adult male:0.042,0.019 and 0.016 mGy/MBq;adult female:0.026,0.027 and 0.019 mGy/MBq)were much higher than those of brain,skin and thyroid(adult male:0.0003,0.0005 and 0.0005 mGy/MBq;adult female:0.0003,0.0005 and 0.0006 mGy/MBq).The range of absorbed dose coefficients of radiosensitive organs such as osteogenic cells,thymus and red marrow was 0.0012-0.0022 mGy/MBq.The absorbed dose coefficient of whole body was 0.0017 mGy/MBq for adult male and 0.0016 mGy/MBq for adult female.The effective dose coefficient of whole body was 0.00458 mSv/MBq for adult male and 0.00455 mSv/MBq for adult female.Conclusion:99mTc-HYNIC-TOC is feasible to be used safely in human beings because the effective dose of whole body is lower than dose constraining.

关 键 词：99mTc标记的经肼基烟酰胺修饰的奥曲肽 生物分布 医用内照射剂量学方法 人体吸收剂量 

分 类 号：R730.4[医药卫生—肿瘤]