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目的探讨99Tcm-MIBI SPECT/CT同机融合显像辅助肺癌放疗靶区定位的价值,分析肿瘤组织摄取99Tcm-MIBI与化疗疗效之间的关系。方法回顾性分析经病理确诊的19例非小细胞肺癌患者,放、化疗前均行99Tcm-MIBISPECT/CT显像,通过感兴趣区技术勾画肿瘤靶区并确定计划靶区;获取感兴趣区放射性计数,计算肿瘤早期摄取比(T/NTe)、延迟摄取比(T/NTd)及肿瘤组织滞留率(RI%),分析T/NTe、T/NTd、RI%与患者临床分期及病理类型的关系。结果 19例患者中99Tcm-MIBI显像阳性18例,修改CT计划靶区15例,占78.9%;明确区分肺不张与肿瘤病灶11例,占57.9%。化疗有效患者T/NTe、T/NTd比值分别为(2.47±0.23)、(2.35±0.19),无效患者分别为(1.72±0.10)、(1.63±0.12),两者差异统计学有意义(P<0.01),两者RI%比较差异无统计学有意义(P>0.05),T/NTe、T/NTd、RI%在不同临床分期、病理类型中差异均无统计学有意义(P>0.05)。结论99Tcm-MIBI SPECT/CT融合显像有助于优化肺癌立体放疗靶区,选取T/NTe=2.0作为预测化疗有效的阈值有较高的准确性,且不受患者临床分期及病理类型的影响。
Objective To investigate the value of 99Tcm-MIBI SPECT / CT fusion imaging in assisting lung cancer radiotherapy target location and to analyze the relationship between tumor tissue uptake 99Tcm-MIBI and chemotherapy efficacy. Methods Nineteen patients with pathologically diagnosed non-small cell lung cancer were retrospectively studied. 99Tcm-MIBISPECT / CT imaging was performed before radiotherapy and chemotherapy. The tumor target area was delineated by the technique of region of interest and the planned target area was determined. The radioactivity The T / NTe, T / NTd and RI of tumor were calculated, and the relationship between T / NTe, T / NTd, RI% and clinical stage and pathological type relationship. Results Of the 19 patients, 99 Tcm-MIBI imaging was positive in 18 cases. Fifteen patients (78.9%) were targeted by modified CT. Atelectasis and tumor lesions were clearly distinguished in 11 cases (57.9%). The ratios of T / NTe and T / NTd were (2.47 ± 0.23) and (2.35 ± 0.19) in patients with chemotherapy effective and (1.72 ± 0.10) and (1.63 ± 0.12) years respectively in patients with chemotherapy, the difference was statistically significant (P (P <0.05). There was no significant difference of T / NTe, T / NTd and RI% in different clinical stages and pathological types (P> 0.05) ). Conclusion 99Tcm-MIBI SPECT / CT fusion imaging is helpful to optimize the target of radiotherapy for lung cancer. T / NTe = 2.0 is the most effective threshold for predicting chemotherapy, and is not affected by the clinical stage and pathological type .