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.     

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.     

18F-FDG PET/CT显像监测胃癌术后复发转移的价值

Objective PET with 18F-fluorodeoxyglucose (FDG) has been used to beth detect and stage a variety of malignancies. The aim of this retrospective study was to evaluate the clinical value of 18F-FDG PET/CT for recurrence and metastasis in gastric carcinoma patients after total gastrectomy. Methods A total of 45 gastric carcinoma patients who underwent total gastrectomy were included. PET/CT scans were obtained for restaging. The " gold standard" of 18F-FDG PET/CT diagnostic accuracy was based on either histopathology or clinical follow-up. By using the t-test from SPSS 11.5, the cut-off of maximum standard-ized uptake values (SUVmax) from 18F-FDG to differentiate benign from malignant lesion at stomach were determined and calculated. Results (1) Of the 45 patients, 22 were suspicion recurrent lesion at stomach. Of the 22 patients, 12 were confirmed to have recurrent lesions. The diagnostic accuracy were 100.0% (12/ 12) for sensitivity, 70.0% (7/10) for specificity, and 86.4% (19/22) for accuracy, respectively. A higher SUVmax in malignant than benign lesion was noted (6.27 ± 3.42 vs 3.92 ± 2.24), though not reached to the significance (t = 1. 862, P > 0.05). (2) For extra-gastric lesion detection, the sensitivity, specificity, and accuracy for region lymph nodes were 78.9% (15/19), 92.3% (24/26), and 86.7% (39/ 45), for peritoneal spreading were 6/9, 97.2% (35/36), 91. 1% (41/45), and for distant sites were 86.7%(13/15), 93.3% (28/30), 91.1% (41/45). (3) False positive were found in eight sites. All were either inflammatory or physiological uptake at intestine. False negative were found in nine sites. Either due to small in size (less than 1.0 cm in diameter), well differentiation of the tumor cell or with a nature of signet ring. Conclusion 18F-FDG PET/CT had a potential to detect local, regional, and distant metastasis in gastric cancer.     

99Tcm-HL91乏氧显像对甲状腺肿瘤的初步临床研究

目的探讨99Tcm-HL91甲状腺肿瘤阳性显像的可行性,分析其诊断效能。方法对6例正常自愿者与70例经甲状腺扫描证实的甲状腺孤立冷结节患者进行99Tcm-HL91显像研究,用肉眼法与半定量分析法对诊断效能予以评价。结果(1)99Tcm-HL91在正常人甲状腺内几乎不摄取,4 h颈部占全身放射性约1.18%;(2)甲状腺99Tcm-HL91乏氧显像结果有4种类型,即热、温、冷结节与不显影,热结节主要见于甲状腺癌;(3)甲状腺癌T/N比值随时间有升高趋势,4 h显示了较好的显像品质;(4)肉眼与半定量法(阈值)判断对甲状腺癌诊断的灵敏度,特异性和准确性分别为77.78%、92.31%、88.57%;88.89%、92.31%、91.42%(T/N比值≥1.08)。2种判断方法之间比较无显著性差异(P>0.05)。结论(1)99Tcm-HL91甲状腺乏氧显像能够鉴别甲状腺孤立冷结节的性质,肉眼法与半定量分析法对甲状腺肿瘤具有相同的诊断效能。(2)推荐用4 h恶性组T/N比值的x-s为诊断阈值,对于进一步判断甲状腺肿瘤性质有重要临床价值。     

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。     

肺肿瘤核素显像的临床应用进展

核素显像在肺癌的诊断、分期、治疗后复发转移的监测、疗效和预后的判断等方面展示了重要的临床价值,日益受到临床的重视。对临床较为常用的67Ga、201Tl、99Tcm和18F等放射性核素及其标记化合物的显像原理、临床应用、优缺点及进展情况进行介绍,并重点介绍了99Tcm甲氧基异丁基异腈(99Tcm-MIBI)、99Tcm-HL91、18F-氟脱氧葡萄糖(18F-FDG)肺肿瘤核素显像的l临床应用进展。     

99Tcm-HL91乏氧显像在甲状腺结节良恶性鉴别诊断中的应用

目的 评价99Tcm4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)对甲状腺结节良恶性鉴别诊断的临床价值.方法 对58例经触诊或超声检查存在甲状腺结节的患者进行99Tcm-HL91甲状腺早期(10 min)及延迟(4 h)平面显像,应用感兴趣区(ROI)技术计算靶/非靶(T/N)比值并进行比较.组间比较采用成组设计两样本均数t检验,率的比较用χ2检验.结果 患者均经手术或细针穿刺病理检查,其中21例为甲状腺癌,37例为甲状腺良性结节.99Tcm-HL91显像诊断甲状腺癌的灵敏度、特异性和准确性分别为85.7%,94.6%和91.4%,不同甲状腺癌病理类型的显像灵敏度差异无统计学意义(χ2=0.778,P＞0.05),但结节越大灵敏度越高.甲状腺癌与甲状腺良性结节组早期及延迟相T/N比值分别为1.07±0.04,1.25±0.03和0.92±0.10,0.91±0.12,组间在10 min时T/N比值差异无统计学意义(t=1.900,P＞0.05),4 h时T/N比值差异有统计学意义(t=3.885,P＜0.001).结论 用99Tcm-HL91乏氧显像判断甲状腺结节的良恶性有一定的临床价值,显像时间以4 h为佳.     

用ROC曲线法分析99Tcm-HL91肺肿瘤阳性显像的诊断效能

目的探讨半定量分析及接受器工作特性(ROC)曲线法在99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)肿瘤阳性显像鉴别肺部良恶性肿块中的价值.方法经CT检查发现肺部肿块的患者50例,均经活组织检查或手术病理检查证实.根据病理检查结果分为恶性组37例和良性组13例.术前行99Tcm-HL91 2 h、4 h平面显像及4 h断层显像,分别使用视觉判断法、半定量分析及ROC曲线法分析显像结果.结果①视觉判断法99Tcm-HL91显像的灵敏度、特异性和准确性分别为97.3%、69.2%和90.0%.②肿瘤/正常肺组织(T/N)比值半定量分析及ROC曲线法恶性组2 h、4 h平面显像及4 h断层显像T/N比值分别为1.52±0.19、1.73±0.28及2.84±0.97;良性组分别为1.20±0.16、1.24±0.20及1.52±0.40.各个时相的曲线下面积分别为0.909±0.056、0.945±0.039、0.953±0.034.从99Tcm-HL91断层显像ROC曲线的界值点找到1个界点(T/N=1.76),以其作为判断良、恶性的诊断阈值,灵敏度、特异性和准确性分别为100%、84.6%和96.0%.③视觉判断法与半定量分析法比较T/N比值半定量分析及ROC曲线法使诊断的灵敏度、特异性和准确性都有提高,尤其特异性.但两种方法间差异无显著性(P均＞0.05).结论半定量分析及ROC曲线法的诊断阈值可进一步提高99Tcm-HL91肺部肿瘤阳性显像的诊断效能.     

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.