Goto Yoshinari, Ihara Koichiro, Kawauchi Shigeto, Ohi Ritsuko, Sasaki Kohsuke, Kawai Shinya
Department of Orrthopedic Surgery, Yamaguchi University School of Medicine, Ube, Japan.
J Orthop Sci. 2002;7(3):304-12. doi: 10.1007/s007760200052.
We evaluated sequential thallium scans on both early images (EI) and delayed images (DI) for 62 patients who had bone and soft tissue lesions. The purpose was to determine whether this technique could be used to ascertain accurately whether lesions were malignant or benign and to predict the response to chemotherapy. The thallium-201 chloride (201Tl) accumulation in malignant tumors and benign lesions was statistically different. Sensitivity, specificity, and accuracy for 201Tl scans in detecting malignant tumors was 94%, 65%, and 82%, respectively, for EI, and 94%, 85%, and 90%, respectively, for DI. On multivariate analysis, significant independent factors for 201Tl uptake were malignant lesions on EI and DI and high cellularity on EI. Thirteen patients with malignant bone and soft tissue tumors underwent 201Tl scans before and after preoperative chemotherapy. There was a good correlation between percentage of tumor necrosis and percentage change of accumulation in lesion-to-normal tissue ration, and the correlation coefficient was higher on EI ( r = 0.801) than on DI ( r = 0.664). These results support the notion that 201Tl scintigraphy, although showing some false-positive and false-negative findings, is a useful tool in the evaluation of either malignant tumors or benign lesions. Furthermore, 201Tl scans on EI provide benefit concerning the evaluation of chemotherapeutic response in patients with malignant bone and soft tissue tumors.
我们对62例患有骨和软组织病变的患者的早期图像（EI）和延迟图像（DI）进行了连续铊扫描。目的是确定该技术是否可用于准确确定病变是恶性还是良性，并预测对化疗的反应。恶性肿瘤和良性病变中氯化铊-201（201Tl）的蓄积在统计学上存在差异。EI检测恶性肿瘤时，201Tl扫描的敏感性、特异性和准确性分别为94%、65%和82%，DI检测时分别为94%、85%和90%。多变量分析显示，201Tl摄取的显著独立因素为EI和DI上的恶性病变以及EI上的高细胞密度。13例患有恶性骨和软组织肿瘤的患者在术前化疗前后进行了201Tl扫描。肿瘤坏死百分比与病变与正常组织比值的蓄积变化百分比之间存在良好相关性，EI上的相关系数（r = 0.801）高于DI（r = 0.664）。这些结果支持以下观点：201Tl闪烁扫描尽管存在一些假阳性和假阴性结果，但在评估恶性肿瘤或良性病变方面是一种有用的工具。此外，EI上的201Tl扫描有助于评估恶性骨和软组织肿瘤患者的化疗反应。
