Thallium-201核素显像在骨肉瘤新辅助化疗疗效评估中的价值

目的 探讨Thallium-201(TI-201)核素显像对骨肉瘤术前新辅助化疗疗效评估的意义.方法 34例骨肉瘤患者在术前新辅助化疗前、后进行TI-201核素显像,对所采集的图像数据进行定性和半定量分析,通过测量肿瘤病灶与正常组织的放射性计数,计算摄取比(UR)和变化率(AR);同时测量肿瘤面积(S),计算面积比(SR).对患者术后肿瘤病理标本进行分析,根据肿瘤坏死率(TNR)将其分为3级,Ⅰ级:TNR＜50%;Ⅱ级:TNR为50%～90%;Ⅲ级:TNR＞90%.将AR、SR与TNR进行直线相关性分析.结果 TNR Ⅰ级(6例)、Ⅱ级(18例)和Ⅲ级(10例)患者的早期相和延迟相AR分别为3.19%±8.40%和-26.29%±63.61%、40.07%±11.95%和39.30%±9.87%、78.32%±8.33%和63.26%±6.06%,AR与TNR之间存在良好相关性(r=0.71).新辅助化疗后,肿瘤面积缩小18例(52.9%),肿瘤面积变化不明显8例(23.5%),肿瘤面积增大6例(17.6%),肿瘤sR与TNR之间无相关性.结论 新辅助化疗后,AR与TNR存在良好的相关性,对骨肉瘤化疗疗效的评估有重要意义.

Value of thallium-201 scintigraphy in assessment of neoadjuvant chemotherapy for osteosarcoma

Objective To investigate the significance of T1-201 scintigraphy for assessment of neoadjuvant chemotherapy for osteosarcoma.Methods Thirty-four cases with osteosarcoma were enrolled into this study.The T1-201 scintigraphy features including uptake ratio (UR) and size ratio (SR) were obtained in both early and delay imaging stages before and after chemotherapy.The responses of chemotherapy were classified into three grades according to the percentage of tumor necrosis in the specimens:necrosis ＜50% as grade 1,necrosis of 50%～90% as grade 2,diffuse necrosis＞90% as grade 3.The alteration ratio (AR) and SR were calculated according to tumor necrosis ratio (TNR).Results Of the 6 patients with grade 1 response,the mean alteration ratios were 3.19%±8.40% and -26.29%±63.61% in early and delay imaging stages,respectively.Among the 18 patients with grade 2 response,the mean alteration ratios were 40.07%±11.95% and 39.30%±9.87%,respectively.Of the 10 patients with grade 3 response,the mean alteration ratios were 78.32%±8.33% and 63.26%±6.06% in early and delay imaging stages,respectively.The results of liner regression analysis of TNR of the surgical specimens showed a significantly positive correlation (r =0.71 ) between AR and TNR.The lesion size was reduced in 18 cases,but unchanged in 8 and increased in 8.The liner regression analysis results showed a negative correlation between SR and TNR.Conclusion The alteration ratio changes significantly after neoadjuvant chemotherapy and has a significantly positive correlation with tumor necrosis ratio.Thallium-201 scintigraphy is helpful in the evaluation of neoadjuvant chemotherapy for osteosarcoma.