99Tcm-HL91肺癌显像的临床应用

目的 探讨~(99)Tc~m-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮后(HL91)显像对肺部肿瘤定性的价值。方法 对32例肺部肿瘤患者注射~(99)Tc~m-HL91后10 min,2、4 h进行显像,将显像结果分为~(99)Tc~m-HL91显像阳性组和阴性组,对~(99)Tc~m--HL91显像阳性患者利用感兴趣区(ROI)技术分别勾画各时相肿瘤(T)与对侧相应部位(N)ROI,计算T/N比值。所有患者均经手术病理检查证实,将显像结果与CT和病理检查结果对照。结果 ~(99)Tc~m-HL91显像灵敏度为82.6％,特异性为100％,准确性为87.5％。CF灵敏度为69.6％,特异性为100％,准确性为78.1％。CT提示肺癌16例中,~(99)Tc~m-HL91显像均阳性。随~(99)Tc~m-HL91显像时间延长,T/N比值增高,10 min为1.620±0.320,2 h为1.737±0.416,4 h为1.909±0.491。10 min与2 h差异无显著性(P>0.05),10 min与4 h差异有显著性(P<0.05)。肺腺癌组与肺鳞癌组各时相T/N比值差异无显著性(P>0.05)。结论 ~(99)Tc~m-HL91显像判断肺肿瘤良恶性有较好价值。     

用99Tcm-HL91显像预测脑肿瘤放疗敏感性

目的应用99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)乏氧显像预测脑肿瘤放疗疗效.方法经临床确诊的30例未治疗的脑肿瘤患者,肘静脉注射99Tcm-HL91 740 MBq后进行早期(10 min)、中期(2 h)和晚期(4 h)显像.应用感兴趣区(ROI)技术勾画并分别测定早、中、晚期肿瘤部位放射性计数(T),以及对侧相应部位放射性计数(N),求出相应T/N比值.检查后患者接受放射治疗,4周后按WHO标准,在放疗科医师协助下进行放疗疗效评价,分为完全缓解(CR),部分缓解(PR),无变化(NC)和进展加重(PD),并与99Tcm-HL91显像结果比较.结果①30例脑肿瘤患者99Tcm-HL91显像早、中、晚各时相的T/N比值分别为1.453±0.292,1.532±0.299和1.607±0.305,各时相间差异均有显著性(P=0.000,双侧).②30例脑肿瘤患者中CR 0例,PR 15例,NC 6例,PD 1例,死亡或失访共8例;放疗有效组(CR+PR)与放疗无效组(NC+PD)99Tcm-HL91显像早、中和晚期相T/N比值分别为1.333±0.277与1.779±0.183,1.409 ±0.274与1.856±0.185和1.484±0.278与1.937±0.191,差异均有显著性(P=0.001,双侧).③受检者均未发现主观性不适和毒副作用.④99Tcm-HL91在鼻、口咽部有明显放射性摄取.结论99Tcm-HL91脑肿瘤显像可预测脑肿瘤的放疗敏感性,对鼻、口咽部肿瘤应用价值较低.     

99 Tcm-HL91 SPECT显像检测急性脑梗死乏氧脑组织的研究

目的：探讨^99Tc^m-4，9．二氮-3，3，10，10-四甲基十二烷-2，11-二酮肟(HL91)脑显像检测急性脑梗死乏氧脑组织的作用。方法：7例正常对照者和21例急性脑梗死患者于起病96h内进行脑^99Tc^m-HL91 SPECT显像和同机CT扫描，并进行图像融合，其中3例首次显像阳性的患者于第7～42天复查SPECT显像(1例3次，另2例各1次)。结果：①对照组未见脑实质有明显放射性浓集。②21例患者中，14例为完全或部分前循环梗死，乏氧显像阳性8例，阳性率为38．1％，乏氧区位于梗死灶周围。其中3例起病后7～42d病情好转者，复查SPECT乏氧显像仍呈阳性，但范围缩小。7例腔隙性梗死者乏氧显像均阴性。结论：^99Tc^m-HL91 SPECT显像可显示脑梗死后脑乏氧组织。     

99Tcm-HL91显像、CT和血清肿瘤标志物测定联合应用诊断肺癌

目的探讨Tc^m-4，9-二氮．3，3，10，10-四甲基十二烷-2，11-二酮肟(HL91)显像、CT、血清肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片断(CYFRA21-1)、神经元特异性烯醇酶(NSE)]测定联合应用对肺癌的诊断价值。方法46例疑为肺癌患者在1周内进行^99Tc^m-HL91 SPECT显像、CT检查和血清肿瘤标志物测定。计算每种方法及三法联合应用诊断肺癌的灵敏度、特异性及准确性。结果最终经病理检查或细胞学诊断证实肺癌26例，经病理检查或治疗后影像学随访确诊肺部良性病变20例。^99Tc^m-HL91 SPECT显像、CT及血清肿瘤标志物测定诊断肺癌的灵敏度、特异性及准确性分别为77％、80％、78％，96％、60％、80％及50％、60％、54％。三法联合应用诊断肺癌的灵敏度、特异性及准确性分别为100％、90％、96％，其综合诊断效能明显优于其中任何一种检查方法。结论^99Tc^m-HL91显像、CT、血清肿瘤标志物测定联合应用在肺部肿瘤良恶性鉴别诊断中有较大价值。     

99Tcm-MIBI肿瘤显像对肺结节的诊断价值

目的 探讨~(99)Tc~m-甲氧基异丁基异腈(MIBI)肺肿瘤显像对肺癌的诊断价值。方法对12例正常对照组、28例肺良性结节、44例肺癌患者行~(99)Tc~m-MIBI肺肿瘤显像,结合影像学表现和半定量指标早期相摄取比值(ER)、延迟相摄取比值(DR)对结节性质进行判断。结果 对照组ER=1.02±0.10,DR=1.01±0.10;肺良性结节组ER=1.15±0.13,DR=1.14±0.13;肺癌组ER=1.51±0.26,DR=1.43±0.21。以ER≥1.28为阳性显像,诊断肺癌的灵敏度为88.6％,特异性85.7％,准确性87.5％;以DR≥1.27为阳性显像,诊断肺癌的灵敏度为84.1％,特异性92.9％,准确性87.5％。结论 ~(99)Tc~m-MIBI肺肿瘤显像对肺良恶性结节的鉴别诊断具较大实用价值。     

99 Tcm-HL91脑缺血半暗带显像的实验研究

目的 观察^99Tc^m－4，9－二氮－3，3，10，10－四甲基十二烷－2，11－二酮肟（HL91）在局部脑缺血模型脑组织中分布特点。方法 建立31只大鼠避部脑缺血模型，对^99Tc^m－HL91在正常大鼠体内以及在动物模型脑组织中的分布进行研究，同时对动物模型脑组织行放射自显影研究。结果 ^99Tc^m－HL91静脉注射后主要分布于肝、肾、小肠，正常脑组织放射性较低。患／健侧大脑中动脉主要供血区（靶区）单位质量放射性比值与对照组相比差异均有显著性，且随时间的延长而逐渐增高。动物模型脑组织自显像图像均可见靶区放射性明显高于对侧镜像部位，经计算机图像分析系统进行图像分析和数据处理后，同一时相靶与非靶区单位面积净吸光度值差异有显著性，各时相靶／非靶比值与对照组比较差异均有显著性，且随注射药物时间的延长而增高。结论 ^99Tc^m－HL91能够选择性地浓集于缺血缺氧的脑组织中，清除延缓，可用于急性脑卒中缺血半暗带的探测。     

用受试者工作特征曲线分析99Tcm-MIBI显像对甲状腺冷结节的诊断效能

目的探讨受试者工作特征（ROC）曲线分析99^Tc^m-MIBI显像对甲状腺冷结节的诊断效能。方法68例99^Tc^mO4^-甲状腺显像为单发冷结节的患者，行99^Tc^m-MIBI甲状腺显像，分别计算肿瘤和对侧正常甲状腺组织（T／N）15min（ER）和120min（DR）摄取比值，以TIN的DR=0．8作为诊断恶性病变的阈值。同时还计算肿瘤和颌下腺（T／S）、肿瘤和心脏（T／n）ER、DR，用ROC曲线分析法找出上述指标对甲状腺癌诊断的最佳阈值。结果经活组织检查或手术病理检查证实良性病变60例，恶性病变8例。半定量分析99^Tc^m-MIBI显像的灵敏度、特异性和准确性分别为100．0％、76．7％和79．4％，从ROC曲线的界值点找到DR最佳界点（TIN=0．995、T／S=0．995、T／H=1．005），以其作为诊断良恶性的阈值，三者的灵敏度分别为100．0％、87．5％、75．0％，特异性各为90．0％、85．0％、83．3％，其曲线下面积（AUC）分别为0．949，0．876，0．867，均大于相应的ER AUC。TIN阈值0．8和0．995对甲状腺癌诊断结果差异有统计学意义（χ^2=6．125，P〈0．05）。结论ROC曲线分析法能提高99^Tc^m-MIBI对甲状腺结节的诊断效能。     

非小细胞肺癌放疗中99Tcm-HL91 SPECT乏氧显像研究

目的通过99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)系列乏氧显像研究非小细胞肺癌放疗前、中和后乏氧的变化.方法拟接受三维适形放疗的非小细胞肺癌患者20例,放疗前1～2 d、放疗过程中(接受30～40 Gy照射)和放疗后1～2 d分别行99Tcm-HL91 SPECT显像.利用感兴趣区(ROI)技术计算肿瘤/对侧相应部位放射性计数比值(T/N),分析放疗不同时期肿瘤乏氧的变化.结果放疗前、中和后显像的T/N(4 h)分别为1.56±0.19,1.40±0.12和1.29±0.13,差异有显著性(P=0.01).结论该实验为研究人体肿瘤再氧合提供了有价值的信息.     

99 Tcm-MIBI显像对周围性肺肿瘤的诊断价值

常规ＣＴ对周围性肺部占位性病变的诊断往往缺乏特异性 ,纤维支气管镜很难检测到周边部的病变 ,而放射性核素肺阳性显像则可鉴别诊断肺部良恶性占位性病变 ,笔者对此进行了研究 ,现报道如下。资料与方法1 研究对象。正常对照组 10例 ,男8例 ,女 2例 ,平均年龄 37 8(32～ 5 8)岁 ,均经临床排除心、肺及乳腺疾病。周围性肺部占位性病变患者 15例 ,男 13例 ,女 2例 ,平均年龄 48 4(30～ 73)岁。均进行ＣＴ、99Ｔｃｍ 甲氧基异丁基异腈 (ＭＩＢＩ)ＳＰＥＣＴ平面及断层显像、胸外科手术及术后病理检查。2 药物及仪器。静脉注射99Ｔｃｍ ＭＩＢ…     

99Tcm-HL91显像用于骨转移瘤的诊断

目的 探讨乏氧显像剂99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)在骨转移瘤诊断中的应用价值.方法 27例骨痛患者,其中19例经病理检查证实为骨转移瘤(未行放化治疗),8例为骨良性病变.所有患者均行99Tcm-亚甲基二膦酸盐(MDP)显像,2 d后注射99Tcm-HL91740 MBq,注射4 h后依据99Tcm-MDP显示的病灶进行断层显像,利用感兴趣区(ROI)技术,计算肿瘤与对侧正常组织的放射性(T/N)比值.采用SPSS 11.0软件进行t检验.结果 19例骨转移患者99Tcm-MDP显像提示的85处病灶,有79处99Tcm-HL91显像呈异常放射性浓聚;经病理检查或临床证实的8例骨良性疾病中,99Tcm-MDP显像提示的12处病灶99Tcm-HL91显像全部呈阴性.HL91断层显像骨转移组和骨良性疾病组的T/N比值分别为1.877±0.288和0.735±0.236,差异有统计学意义(t=13.065,P＜0.05).肺癌、前列腺癌骨转移病灶的T/N比值分别为1.915±0.344和1.825±0.175,2种病理类型间差异无统计学意义(t=1.378,P＞0.05).结论 99Tcm-HL91显像在骨骼良恶性病变的鉴别中可能有一定价值.     

^99Tc^m-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

目的评价^99Tc^m-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟（HL91）乏氧显像在恶性肿瘤治疗后随访中的价值。方法37例胸部和头颈部恶性肿瘤患者在治疗结束后3—12个月的临床随访中,CT检查怀疑肿瘤残余、复发或转移,再行^99Tc^m-HL91乏氧显像。目测定性分析,判定乏氧显像阳性病例,再用感兴趣区（ROI）技术对阳性病例进行半定量分析,计算肿瘤部位（T）与对侧相应部位或头皮（NT）的放射性比值（T／NT）,并采用成组设计两样本均数t检验进行比较。以鼻咽内镜检查、病理活组织检查结果和12个月的临床随访资料作为判断肿瘤残余、复发或转移的依据,计算^99Tc^m-HL91显像和cT的诊断效能。结果37例患者中,无肿瘤局部残余或复发病灶者19例,存在肿瘤局部残余或复发病灶者11例,有远处转移病灶者7例。（1）无肿瘤局部残余或复发组与肿瘤局部残余或复发组的T／NT比值分别为1．18±0．14和1．58±0．16,两者差异有统计学意义（t=4．87,P〈0．001）。（2）^99Tc^m-HL91显像监测肿瘤局部残余或复发的灵敏度72．73％（8／11）,特异性89．47％（17／19）,准确性83．33％（25／30）;CT监测肿瘤局部残余或复发的灵敏度63．64％（7／11）,特异性84．21％（16／19）,准确性76．67％（23／30）。^99Tc^m-HL91显像与CT结果一致的有21例患者,^99Tc^m-HL91显像与CT联合监测此21例肿瘤残余或复发的灵敏度4／4,特异性94．12％（16／17）,准确性95．24％（20／21）。（3）7例转移患者,^99Tc^m-HL91显像阳性4例,CT均阳性。结论^99Tc^m-HL91乏氧显像对恶性肿瘤治疗后局部残余、复发或转移灶的鉴别有一定价值,与CT联合可有效提高对恶性肿瘤治疗后局部残余、复发或转移灶的早期诊断效能。     

非小细胞肺癌99Tcm-HL91显像与恶性程度、HIF-1α表达的相关性

目的 探讨非小细胞肺癌^99Tc^m-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟（HL91）显像与其恶性程度、乏氧诱导因子-1α（HIF-1α）表达的关系.方法 35例非小细胞肺癌患者,注射^99Tc^m-HL91后4 h进行胸部前后位、后前位平面及断层显像,利用感兴趣区（ROI）技术,计算肿瘤与对侧正常组织（T/N）的放射性比值.所有患者均行组织病理学检查,标本行HE染色、免疫组织化学染色.结果 ^99Tc^m-HL91平面显像：35例非小细胞肺癌患者中30例显像阳性;断层显像：33例显像阳性.定量分析：4 h断层像T/N比值明显高于平面像（t=10.619,P=0.000）;HL91显像的T/N比值与肺癌细胞恶性程度相关（r=0.626,P=0.000）,鳞癌、腺癌之间的T/N比值差异无显著性（t=0.981,P=0.330）.HIF-1α主要表达于肺癌细胞胞核及胞质,肿瘤间质细胞也可见少量表达,肿瘤坏死区周围及肿瘤浸润边缘部的癌细胞HIF-1α表达明显增多.鳞癌、腺癌间的HIF-1α表达差异无显著性（ZC=1.295,P=0.730）,HIF-1α表达强弱与肺癌细胞恶性程度相关（rs=0.467,P=0.005）,与肿瘤大小无关.非小细胞肺癌各组织学分级HL91显像T/N比值与HIF-1α表达强弱均高度相关（r=0.756～0.893,P＜0.05）.结论 HL91显像的T/N比值与肺癌细胞恶性程度呈中度相关,与恶性肿瘤细胞HIF-1α表达呈高度相关.HL91显像可以用来预测肿瘤恶性程度及放、化疗疗效.     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.