^99mTc-MIBI脑显像预测高分级脑胶质瘤同步放化疗疗效的临床研究

目的探讨99m锝-甲氧基异丁基异晴（technetium-99m methoxyisobutylisonitrile，^99mTc-MIBI）脑显像预测高分级脑胶质瘤同步放化疗疗效的可能性。方法用SPECT／CT对67例高分级脑胶质瘤进行脑显像，于放化疗前肘静脉注射^99mTc-MIBI30mCi，注射后30分钟和120分钟分别行早期相和延期相显像，计算肿瘤感兴趣区（region of interest，ROI）与对侧正常相应部位早期摄取比值（T／Ne）、延期摄取比值（T／Nd）和滞留率（RI％）。所有患者给予术后病灶三维适形放疗和替莫唑胺（temozolomide，TMZ）同步化疗，随后给予6个周期的TMZ辅助化疗。结果放化疗有效组49例（71．1％），中位生存期（MST）19月；无效组18例（28．9％），MST11月，两者MST比较差异有统计学意义（P〈0．05），前者T／Ne、T／Nd和RI％值为4．65±2．17、6．67±3．32及（16．11±2．35）％；后者为6．14±2．06、4．47±2．57及（5．40±2．61）％，T／Ne和T／Nd值比较差异无统计学意义（P〉0．05），RI％值比较差异有统计学意义（P〈0．05）。结论99mTc-MIBI脑显像中RI％对高分级脑胶质瘤同步放化疗疗效有一定的预测作用。

Role of 99mTc-MIBI brain image in predicting clinical response of concurrent radiochemotherapy for high grade glioma

Objective To investigate the role of technetium-99m methoxyisobutylisonitrile （99mTc-MIBI） imaging in predicting the response of concurrent radiochemotherapy in treatment of high grade glioma. Methods SPECT/CT brain scan was performed in patients with high grade glioma. Before treatment, 30 mCi 99mTc-MIBI was administered via ulnar vein. Early phase and delayed phase images were taken 30 rain and 120 rain after administration, respectively. T/Ne, T/Nd and RI% were calculated and compared between region of interest （ ROI ） and normal counterparts. All postoperative patients were treated with concurrent 3 dimension conformal radiotherapy and temozolomide （TMZ） chemotherapy followed by 6 months of TMZ chemotherapy alone. Results The median survival times of 49 （71.1% ） responsive patients and 18（28.9%） unresponsive patients were significantly different（ 19 months vs 11 months,P 〈 0.05）. The T/Ne,T/Nd and RI% of both groups were 4.65 ±2.17 vs 6.14± 2.06,6.67± 3.32 vs 4.47±2.57, （16.11 ± 2.35）% vs （5.40 ±2.61 ）% ,respectively. The differences in T/Ne and T/Nd were not significant （P 〉 0.05 ）,while the difference in RI% was statisitically significant （ P 〈 0.05 ）. Conclusion RI% of 99mTc-MIBI is a potential predictor of the response of concurrent chemoradiotherapy in treatment of high grade glioma.