PET-CT评估肝恶性肿瘤患者^(90)钇树脂微球选择性内放射治疗肝肺分流分数效果  

PET-CT evaluation of the effectiveness of selective internal radiation therapy with^(90)Y resin microspheres on liver-lung shunt fraction in patients with hepatic malignant tumors

作　　者：王添艺 朱荣华 WANG Tianyi;ZHU Ronghua(Department of Imaging Medicine and Nuclear Medicine,the Third Affiliated Hospital of Naval Medical University,Shanghai 201805,China)

机构地区：[1]海军军医大学第三附属医院影像医学与核医学科,上海201805

出　　处：《中国研究型医院》2024年第2期7-10,共4页Chinese Research Hospitals

摘　　要：目的研究肝恶性肿瘤患者^(90)钇(^(90)Y)树脂微球选择性内放射治疗(SIRT)后肺内放射性活度及其变化规律,以进一步提高临床治疗的安全性。方法回顾性分析8例肝恶性肿瘤患者接受^(90)Y SIRT后即刻PET-CT扫描图像。术前患者接受^(99m)Tc-MAA肺灌注显像评估,评估结果提示肺分流分数<20%,符合国际接受治疗的标准。在PET-CT扫描中测量肝内肿瘤和两肺的最大标准摄取值(SUVmax),并计算肺分流分数(L/T SUVmax)。通过相关性分析了解L/T SUVmax与注射^(90)Y树脂微球放射性活度的相关性。3个月后随访患者影像资料,评估治疗效果和肺放射性损伤情况。结果8例接受^(90)Y SIRT的肝恶性肿瘤患者的L/T SUVmax均<15%,L/T SUVmax与^(90)Y树脂微球放射性活度有显著的正相关性(r=0.854,P<0.01)。结论^(90)Y SIRT肝肺分流分数明显低于国际标准,肝肺分流分数与^(90)Y树脂微球注射剂量呈正相关。Objective To study the variation of pulmonary radioactivity and its pattern in patients with hepatic malignant tumors undergoing^(90)Y resin microspheres selective internal radiation therapy(SIRT),aiming to enhance the safety of clinical treatment.Methods Eight patients with hepatic malignant tumors who underwent^(90)Y SIRT were retrospectively analyzed,and immediate PET-CT scan images were obtained.Preoperatively,patients underwent^(99m)Tc-MAA pulmonary perfusion imaging evaluation,with results indicating a pulmonary shunting fraction<20%,meeting the international treatment eligibility criteria.Maximum standard uptake values(SUVmax)of hepatic tumors and both lungs were measured on PET-CT scans,and the lung-to-liver(L/T)SUVmax ratio(L/T SUVmax)was calculated.Correlation analysis was performed to assess the relationship between L/T SUVmax and injected radioactivity of^(90)Y resin microspheres.Patients were followed up at 3 months to evaluate treatment efficacy and pulmonary radiation injury.Results All 8 patients receiving^(90)Y SIRT had L/T SUVmax<15%,showing a significant positive correlation between L/T SUVmax and the injected radioactivity of^(90)Y resin microspheres(r=0.854,P<0.01).Conclusion The lung shunting fraction in^(90)Y SIRT for hepatic malignant tumors is significantly lower than the international standard,and it correlates positively with the dosage of injected^(90)Y resin microspheres.

关 键 词：放射学 介入性 钇放射性同位素 放射疗法 微球体 安全性 

分 类 号：R735.7[医药卫生—肿瘤]