SPECT/CT融合显像在骨转移瘤患者^(125)I粒子植入术后剂量验证中的应用价值  

The value of SPECT/CT fusion imaging for post-implantation dose verification of^(125)I particles in patients with bone metastases

作　　者：陆海健 周勇 童谷一 胡红燕 庄丁勤 LU Haijian;ZHOU Yong;TONG Guyi;HU Hongyan;ZHUANG Dingqin(Department of Nuclear Medicine,Zhejiang Jinhua Guangfu Tumor Hospital,Jinhua,Zhejiang Province 321000,China)

机构地区：[1]浙江金华广福肿瘤医院核医学科,浙江金华321000

出　　处：《实用放射学杂志》2024年第2期306-310,共5页Journal of Practical Radiology

基　　金：金华市公益性技术应用研究项目(2022-4-212)。

摘　　要：目的探讨单光子发射计算机断层扫描/计算机体层成像(SPECT/CT)融合显像在骨转移瘤患者^(125)I粒子植入术后剂量验证中的应用价值。方法选取40例转移性骨肿瘤并行^(125)I粒子植入治疗的患者,在^(125)I粒子植入术后24 h内,对患者行SPECT/CT融合显像并计算出单位体积内放射性计数值(RPU)。再使用治疗计划系统(TPS)获取SPECT/CT融合显像结果的等剂量曲线分布图,计算肿瘤靶区覆盖率。通过对比患者术前及术后1月的临床疗效,包括局部肿瘤缓解情况、疼痛评估、生活质量评价和血清碱性磷酸酶(ALP)水平,应用受试者工作特征(ROC)曲线评价肿瘤靶区覆盖率对术后疗效的预测价值。结果靶区平均植入粒子数量为(32.52±12.87)粒。^(125)I粒子植入24 h内,SPECT/CT融合显像分析证实放射性浓聚区RPU与患者所接受平均剂量具有较强正相关性(r=0.786,P<0.05)。肿瘤靶区覆盖率对局部肿瘤缓解情况的预测曲线下面积(AUC)为0.789,对止痛效果的预测AUC为0.757,对生活质量改善的预测AUC为0.804,对ALP水平变化的预测AUC为0.833。结论SPECT/CT融合显像可用于^(125)I粒子治疗转移性骨肿瘤术后的剂量验证,并对临床疗效具有一定预测价值。Objective To investigate the value of single photon emission computed tomography/computed tomography(SPECT/CT)fusion imaging for post-implantation dose verification of^(125)I particles in patients with bone metastases.Methods Forty patients with metastatic bone tumors treated with^(125)I particles implantation were selected.Within 24 h after^(125)I particles implantation,patients underwent SPECT/CT fusion imaging and the radioactivity per unit(RPU)was calculated.The treatment planning system(TPS)was then used to obtain the isodose profiles of SPECT/CT fusion imaging results and to calculate the tumor target coverage.The patient’s preoperative and postoperative 1 month clinical outcomes,including local tumour remission,pain assessment,quality of life and serum alkaline phosphatase(ALP)levels were compared,and a receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of tumor target coverage on postoperative outcomes.Results The mean number of particles implanted in the target area was 32.52±12.87.Within 24 h of^(125)I particles implantation,SPECT/CT fusion imaging analysis confirmed a strong positive correlation between the RPU of the radioactive concentration area and the mean dose received by the patient(r=0.786,P<0.05).The predicted area under the curve(AUC)for local tumor remission,pain relief,quality of life improvement and change in ALP levels was 0.789,0.757,0.804 and 0.833,respectively.Conclusion SPECT/CT fusion imaging can be used for postoperative dose verification of^(125)I particles for metastatic bone tumors and has some predictive value for clinical outcomes.

关 键 词：骨转移瘤 单光子发射计算机断层扫描/计算机体层成像融合显像 ^(125)I粒子植入术 预测价值 

分 类 号：R738.1[医药卫生—肿瘤] R445.6[医药卫生—临床医学] R817.4