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1、分化型甲状腺癌不同部位转移灶131碘SPECT/CT影像学数据分析吴震宇王辉（上海交通大学医学院附属新华医院核医学科，上海200092）【摘要】目的对分化型甲状腺癌（DTC）不同部位转移灶行131碘治疗后48h131碘SPECT/CT显像，将所获得的影像数据进行分析比较，对131碘治疗DTC剂量的制定提供依据。方法对20例共53处转移灶服131碘48h后行SPECT/CT显像，利用软件计算转移灶体积、肿瘤/非肿瘤比值、摄碘率、单位体积活度、CT值等相关数据，分析不同转移部位的数据特点，并将各数据与
2、转移灶治疗效率进行相关性分析。结果①骨骼转移灶单位体积的131碘摄取量明显低于其他部位转移（1.01±1.23GBq/cm3，P=0,029；0.463,0.003），且疗效最差；②影响疗效最主要的因素是病灶的体积，软组织、肺、淋巴结病灶的体积越小，则治疗效果越好，（r=-0.932,-0.897,-0.966，P=0.021,0.000,0.000），而骨转移的体积与疗效的相关性并不显著（r=-0.469，P=0.078）；③如病灶部位CT扫描未发现局部破坏或结节形成，则治疗效果最好，均可一次清
3、除病灶。结论不同部位转移灶的摄碘能力不同，这导致了治疗效果的巨大差异，治疗前应测定各转移部位的影像学数据，个体化制定治疗计划。【关键词】分化型甲状腺癌；SPECT/CT；转移灶；剂量学【中图分类号】R736.1【文献标志码】A131I-SPECT/CTimagingdataanalysisondifferentsiteofmetastasesindifferentiatedthyroidcancerWUZhen-yuWANGHui(DepartmentofNuclearMedicine,Xinhu
4、aHospital,ShanghaiJiaotongUniversitySchoolofMedicine,Shanghai200092,China)[Abstract]ObjectiveForthepurposeofthedosimetryof131-iodinetherapyindifferentiatedthyroidcarcinoma(DTC),weanalyzedtheimagedataof131-iodine-SPECT/CTscanat48honDTCandcomparedmetast
5、aticindifferentsites.Methods131-iodine-SPECT/CTimagingdataof20patientswith53metastaseswereusedtocalculatethevolume,T/Nratio,iodineuptakerate,radioactivityperunit,CTvalueandotherrelevantdatabysoftware.Analysethecorrelationimagingdataandtheefficiencyof1
6、31-iodinetreatmentinDTC.Results①Radioactivityperunitvolumeofbonemetastaseswassignificantlylowerthanotherparts(1.01±1.23GBq/cm3,P=0,029;0.463,0.003,respectively),andtheefficacyistheworst;②Themostimportantfactorinfluencingefficacyisthesizeoflesions,thes
7、mallersofttissue,lung,lymphnodesweredetectedbyCT,thebetterefficacyoftreatmentwereobserved(r=-0.932,-0.897,-0.966,P=0.021,0.000,0.000,respectively)，andthecorrelationinbonemetastasiswasnotsignificant(r=-0.469,P=0.078);③Whenlocaldamageinbonemetastasisorn
8、oduleinlungmetastasiswerenotfoundinCTscan,thetreatmentismostefficient,whichcanbetotallyremovedafteronetherapy.ConclusionDTCmetastaticlesionsindifferentsitehaddifferentiodineuptakecapacity,whichleadstohugedifferencesintherapyefficiency.Dataanal
