目的探讨甲状腺^(99m)TcO_(4)^(-)显像ROI比值代替24 h摄碘率(RAIU)个体化治疗甲亢的可行性。方法回顾性分析2019年1~6月在南方医科大学南方医院核医学科进行^(131)I治疗132例患者的临床资料,根据患者3 h/24 h RAIU峰值比是否前移分为...目的探讨甲状腺^(99m)TcO_(4)^(-)显像ROI比值代替24 h摄碘率(RAIU)个体化治疗甲亢的可行性。方法回顾性分析2019年1~6月在南方医科大学南方医院核医学科进行^(131)I治疗132例患者的临床资料,根据患者3 h/24 h RAIU峰值比是否前移分为高峰前移组(≥80%)和无高峰前移组(<80%)。高峰前移组:采用Marinelli公式法,^(131)I治疗剂量=甲状腺质量×计划量/24 h RAIU;无高峰前移组:分析ROI比值与24 h RAIU相关性,依据换算关系代入Marinelli公式,^(131)I治疗剂量=甲状腺质量×计划量/(ROI比值换算关系)。比较两组患者一般资料(年龄、性别、抗甲状腺药物种类以及停用时间)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、促甲状腺受体自身抗体(TRAb)、抗甲状腺过氧化物酶(TPOAb)、甲状腺面积、甲状腺质量、^(131)I治疗剂量;并随访1年,观察其临床疗效。采用ROC曲线分析治疗后两组ROI比值。结果ROI比值与24 h RAIU呈显著正相关(Y=58.13+0.2X,R2=0.118,P<0.05),代入Marinelli公式获新公式:^(131)I治疗剂量=甲状腺质量×计划量/(58.13+0.2×ROI比值)%。治疗前两组的^(131)I治疗剂量、FT4、FT3、TRAb、3 h及24 h RAIU、甲状腺面积、甲状腺质量、ROI比值差异具有统计学意义(P<0.05);治疗3月后两组的FT4、FT3、TRAb、TPOAb、甲状腺面积、甲状腺质量、ROI比值、有效率、甲减率、治愈率、缓解率、无效率差异均无统计学意义(P>0.05);随访1年,两组的甲亢、甲减、治愈例数构成比比较差异仍无统计学意义(P>0.05);ROC曲线分析治疗3月后ROI比值预测甲亢复发、甲减最佳临界值分别约15.79、6.33。结论甲状腺^(99m)TcO_(4)^(-)显像ROI比值可用于个体化治疗甲亢计算^(131)I剂量,该方法有助于患者的协助诊治,可以判断预后。展开更多
Technetium-99m(^(99m)Tc)is the most used(>80%)radionuclide in the clinical nuclear diagnostic imaging procedure.The traditional approach to preparing ^(99m)Tc-based imaging agents utilizes stannous chloride(SnCl_(2...Technetium-99m(^(99m)Tc)is the most used(>80%)radionuclide in the clinical nuclear diagnostic imaging procedure.The traditional approach to preparing ^(99m)Tc-based imaging agents utilizes stannous chloride(SnCl_(2))for the reduction of noncomplexing pertechnetate(^(99m)TcO_(4)^(−))to low-valent Tc[e.g.,Tc(IV)].This process,however,is difficult to control precisely and usually results in toxic SnCl_(2) residue and remaining 99mTc(VII),both of which are destructive to humans.Herein,we report a new strategy for preparing^(99m)TcO_(4)^(−)-labeled agents without adding any reductants.The deliberately designed nanoscale cationic polymeric network(SCU-CPN-3)shows excellent affinity for^(99m)TcO_(4)^(−)even at trace levels originating from the strong p-πinteraction with^(99m)TcO_(4)^(−).Impressively,record-fast labeling kinetics are observed,where almost quantitative labeling efficacy(>96%)can be achieved within 1 min,giving rise to a short labeling time and simple operation using a clinical kit.Both single-photon emission computed tomography(SPECT)images and ex vivo biodistribution of different tumor model analyses verify the potential feasibility of this strategy for tumor imaging.展开更多
文摘目的探讨甲状腺^(99m)TcO_(4)^(-)显像ROI比值代替24 h摄碘率(RAIU)个体化治疗甲亢的可行性。方法回顾性分析2019年1~6月在南方医科大学南方医院核医学科进行^(131)I治疗132例患者的临床资料,根据患者3 h/24 h RAIU峰值比是否前移分为高峰前移组(≥80%)和无高峰前移组(<80%)。高峰前移组:采用Marinelli公式法,^(131)I治疗剂量=甲状腺质量×计划量/24 h RAIU;无高峰前移组:分析ROI比值与24 h RAIU相关性,依据换算关系代入Marinelli公式,^(131)I治疗剂量=甲状腺质量×计划量/(ROI比值换算关系)。比较两组患者一般资料(年龄、性别、抗甲状腺药物种类以及停用时间)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、促甲状腺受体自身抗体(TRAb)、抗甲状腺过氧化物酶(TPOAb)、甲状腺面积、甲状腺质量、^(131)I治疗剂量;并随访1年,观察其临床疗效。采用ROC曲线分析治疗后两组ROI比值。结果ROI比值与24 h RAIU呈显著正相关(Y=58.13+0.2X,R2=0.118,P<0.05),代入Marinelli公式获新公式:^(131)I治疗剂量=甲状腺质量×计划量/(58.13+0.2×ROI比值)%。治疗前两组的^(131)I治疗剂量、FT4、FT3、TRAb、3 h及24 h RAIU、甲状腺面积、甲状腺质量、ROI比值差异具有统计学意义(P<0.05);治疗3月后两组的FT4、FT3、TRAb、TPOAb、甲状腺面积、甲状腺质量、ROI比值、有效率、甲减率、治愈率、缓解率、无效率差异均无统计学意义(P>0.05);随访1年,两组的甲亢、甲减、治愈例数构成比比较差异仍无统计学意义(P>0.05);ROC曲线分析治疗3月后ROI比值预测甲亢复发、甲减最佳临界值分别约15.79、6.33。结论甲状腺^(99m)TcO_(4)^(-)显像ROI比值可用于个体化治疗甲亢计算^(131)I剂量,该方法有助于患者的协助诊治,可以判断预后。
基金supported by the Intergovernmental International Cooperation of the National Key R&D Program of China(grant no.2022YFE0105300)the National Natural Science Foundation of China(grant nos.21825601,22306136,21790374,22176139,and 22206144)+4 种基金the China National Postdoctoral Program for Innovative Talents(grant no.BX2021206)the China Postdoctoral Science Foundation(grant no.2021M702390)the Natural Science Foundation of Jiangsu(grant no.BK20230510)the National Key R&D Program of China(grant no.2018YFB1900203)the New Cornerstone Science Foundation through the XPLORER PRIZE.
文摘Technetium-99m(^(99m)Tc)is the most used(>80%)radionuclide in the clinical nuclear diagnostic imaging procedure.The traditional approach to preparing ^(99m)Tc-based imaging agents utilizes stannous chloride(SnCl_(2))for the reduction of noncomplexing pertechnetate(^(99m)TcO_(4)^(−))to low-valent Tc[e.g.,Tc(IV)].This process,however,is difficult to control precisely and usually results in toxic SnCl_(2) residue and remaining 99mTc(VII),both of which are destructive to humans.Herein,we report a new strategy for preparing^(99m)TcO_(4)^(−)-labeled agents without adding any reductants.The deliberately designed nanoscale cationic polymeric network(SCU-CPN-3)shows excellent affinity for^(99m)TcO_(4)^(−)even at trace levels originating from the strong p-πinteraction with^(99m)TcO_(4)^(−).Impressively,record-fast labeling kinetics are observed,where almost quantitative labeling efficacy(>96%)can be achieved within 1 min,giving rise to a short labeling time and simple operation using a clinical kit.Both single-photon emission computed tomography(SPECT)images and ex vivo biodistribution of different tumor model analyses verify the potential feasibility of this strategy for tumor imaging.
