^(99)Tc^m-HYNIC-TOC-生长抑素受体肿瘤显像的临床应用

Preliminary Clinical Application of ^(99)Tc^m-HYNIC-TOC Imaging in Somatostatin Receptor-positive Tumors

目的评价自制生长抑素受体显像剂99Tcm-HYNIC-TOC在生长抑素受体阳性肿瘤诊断中的应用价值。方法采用本室自己制备的HYNIC-TOC药盒,对44例患者进行99Tcm-HYNIC-TOC显像,其中包括神经内分泌源性肿瘤22例,非神经内分泌源性肿瘤10例,以及对照病例12例。所有病例均经手术病理证实,并有临床实验室检查或1～2项其他影像检查结果。静注99Tcm-HYNIC-TOC370MBq后,于1、4h行局部及全身显像,阳性病例行单光子发射/X线透射断层显像(SPECT/CT)。4例病例曾行111In-pentetreotide显像,10例行肾上腺髓质显像(131I-MIBG)对照,1例非霍奇金淋巴瘤患者行治疗前后的99Tcm-HYNIC-TOC显像。结果32例中共检出生长抑素受体阳性肿瘤19例,99Tcm-HYNIC-TOC显像在生长抑素受体阳性肿瘤的灵敏度、特异性和准确性分别为82.6%、100%、87.5%。99Tcm-HYNIC-TOC的分布与111In-pentetreotide基本类似,表现为正常的肝、脾和肾的摄取。注射后1h显像,99Tcm-HYNIC-TOC在肿瘤中有较高的摄取。99Tcm-HYNIC-TOC显像在6例病例中首先检出肿瘤病灶。与131I-MIBG显像比较,99Tcm-HYNIC-TOC显像检出更多病灶。1例非霍奇金淋巴瘤患者治疗后的显像与治疗前比较,病变缩小。结论99Tcm-HYNIC-TOC可有效地定位与诊断生长抑素受体阳性肿瘤。

To evaluate the effect of 99 Tc m -HYNIC-TOC imaging in localization of somatostatin receptor-positive tumors.Methods Forty-four patients were involved in this study,including22neuroendocrine tumors,10non-neuroendrocrine tumors and12benign diseases.All patients were confirmed by histopathologic diagnosis,and had clinical laboratory data,or1～2other imaging procedures.Regional,whole body and SPECT/CT (in positive cases)imagings were acquired at1and4hours after an intravenous injection of370MBq 99 Tc m -HYNIC-TOC. 99 Tc m -HYNIC-TOC imaging was compared with 111 In-petetreotide imaging in4cases,and with 131 I-MIBG imaging in10cases. 99 Tc m -HYNIC-TOC imaging was performed before and after treatment in1non-Hodgkins lymphoma (NHL)patient.Results The positive imagings were observed in19of32cases.The sensitivity,specificity,and accuracy of 99 Tc m -HYNIC-TOC imaging for somatostatin receptor-positive tumors are82.6%,100%,and87.5%,respectively.The distribution in vivo of 99 Tc m -HYNIC-TOC is similar to that of 111 In-petetreotide,and showed high physiological uptake in liver,spleen,and kidneys. 99 Tc m -HYNIC-TOC imaging demonstrated intense tumor sites uptake at1hour after injection,and revealed the lesions first in6patients among the imaging modalities,and more lesions that had not been revealed by 131 I-MIBG imaging.Compared with imaging before treatment,99 Tc m -HYNIC-TOC imaging confirmed the tumor regression after treatment in1NHL.Conclusions 99 Tc m -HYNIC-TOC is promising for the diagnosis and localization of somatostatin receptor-positive tumors.