Suppr超能文献

[利用99锝-甲氧基异丁基异腈脑单光子发射计算机断层显像评估脑胶质瘤患者的恶性程度及预后]

[Evaluation for degree of malignancy and prognosis of patients with brain glioma using 99Tcm-MIBI brain SPECT].

作者信息

Fan Yi-Xiang, Luo Rong-Cheng, Li Gui-Ping, Zheng Hang, Huang Kai

机构信息

Department of Oncology, Nanfang Hospital,The First Military Medical University, Guangzhou, Guangdong, PR China.

出版信息

Ai Zheng. 2004 Jun;23(6):689-92.

Abstract

BACKGROUND & OBJECTIVE: It is important and useful to evaluate the degree of malignancy for therapeutic scheme and prognosis evaluation. Traditional imaging methods such as CT and MRI play the important role in distinguishing glioma, but sometimes it was still difficult to diagnose accurately only having the aid of these anatomic information. Stereotaxic needle biopsy is an invasive method and indicates only local pathologic change, sometimes the error of sample collection will result in inaccurate grading. 18F-FDG PET can reflect the glucose metabolic rate of tumor directly and is thought as the most useful method, but the cost is too high so that it cannot be used widely at present. This study measured (99)Tc(m)-MIBI uptake in the patients with different pathological types using (99)Tc(m)-MIBI brain scan and evaluated the malignant degree of astrocytoma and its prognosis.

METHODS

Fifty-two patients with glioma and 15 collators were retrospectively analyzed. (99)Tc(m)-MIBI was injected into each patient via elbow vein. SPECT was performed 20 min(early phase) and 2 h (delayed phase) after injection. (1)Diagnostic indices such as sensitivity, specificity, and accuracy were calculated. (2) The tumor to non-tumor ratios (T/N) were calculated according to ROI and compared between groups of different malignancy grading by t-test. (3) The survival time (by means of mean survival time, MST) after (99)Tc(m)-MIBI brain SPECT was follow-up surveyed. According to T/N ratios, the patients were divided into four groups. The MST was compared between four groups by t-test.

RESULTS

(1) Among 52 cases of glioma, 44 showed positive and 2 collators showed false-positive on (99)Tc(m)-MIBI SPECT and the sensitivity, specificity, and accuracy were 84.6%, 86.7%, and 85.1%,respectively. (2) On early phase and delayed phase,when T/N ratio was compared, there was no significant difference between grade-I astrocytoma and grade-II astrocytoma (P >0.05), nor was between patients with ependymocytomas and patients with oligodendrogliomas (P >0.05). There was significantly different between every other two groups (P< 0.001),showing the higher the malignancy of astrocytoma,the more the T/N ratio. (3)Comparison of MST indicated that the more the T/N ratio, the shorter the MST. MST in group with T/NT ratio of 1.2-2.0 was significantly longer than that in group with T/NT ratio of 4.1-(t=5.412,P< 0.001) and that in group with T/N ratio of 3.1-4.0(t=4.418,P< 0.001). MST in group of 2.1-3.0 was significantly longer than that in group of 4.1-(t=3.382, 0.002< P< 0.005) and that in group of 3.1-4.0 (t=2.389,0.02< P< 0.05). MST showed no significant difference between the group of 1.2-2.0 and the group of 2.1-3.0 (t=1.691,P >0.05), nor did between the group of 3.1-4.0 and group of 4.1-(t=1.629,P >0.05).

CONCLUSION

As a noninvasive technique, (99)Tc(m)-MIBI brain SPECT is effective to diagnose brain glioma and distinguish its malignancy degree. This method, by monitoring the T/N ratio closely, is useful to discriminate tumor viability and determine the prognosis of patients.

摘要

背景与目的

评估恶性程度对于治疗方案的制定及预后评估具有重要意义且很有用。传统的影像学方法如CT和MRI在鉴别胶质瘤方面发挥着重要作用,但有时仅借助这些解剖学信息仍难以准确诊断。立体定向针吸活检是一种有创方法,仅能显示局部病理变化,有时样本采集误差会导致分级不准确。18F-FDG PET能直接反映肿瘤的葡萄糖代谢率,被认为是最有用的方法,但成本过高,目前无法广泛应用。本研究采用99Tcm-MIBI脑显像测量不同病理类型患者的99Tcm-MIBI摄取情况,评估星形细胞瘤的恶性程度及其预后。

方法

回顾性分析52例胶质瘤患者及15例对照者。经肘静脉向每位患者注射99Tcm-MIBI。注射后20分钟(早期)和2小时(延迟期)行SPECT检查。(1)计算敏感性、特异性和准确性等诊断指标。(2)根据感兴趣区计算肿瘤与非肿瘤比值(T/N),并通过t检验比较不同恶性分级组之间的差异。(3)对99Tcm-MIBI脑SPECT检查后的生存时间(采用平均生存时间,MST)进行随访调查。根据T/N比值将患者分为四组。通过t检验比较四组之间的MST。

结果

(1)52例胶质瘤患者中,44例在99Tcm-MIBI SPECT上显示阳性,2例对照者显示假阳性,敏感性、特异性和准确性分别为84.6%、86.7%和85.1%。(2)在早期和延迟期,比较T/N比值时,Ⅰ级星形细胞瘤与Ⅱ级星形细胞瘤之间无显著差异(P>0.05),室管膜瘤患者与少突胶质细胞瘤患者之间也无显著差异(P>0.05)。其他任意两组之间均有显著差异(P<0.001),表明星形细胞瘤恶性程度越高,T/N比值越高。(3)MST比较显示,T/N比值越高,MST越短。T/N比值为1.2 - 2.0组的MST显著长于T/N比值为4.1 - 组(t = 5.412,P<0.001)及T/N比值为3.1 - 4.0组(t = 4.418,P<0.001)。T/N比值为2.1 - 3.0组的MST显著长于T/N比值为4.1 - 组(t = 3.382,0.002<P<0.005)及T/N比值为3.1 - 4.0组(t = 2.389,0.02<P<0.05)。T/N比值为1.2 - 2.0组与T/N比值为2.1 - 3.0组之间的MST无显著差异(t = 1.691,P>0.05),T/N比值为3.1 - 4.0组与T/N比值为4.1 - 组之间也无显著差异(t = 1.629,P>0.05)。

结论

作为一种无创技术,99Tcm-MIBI脑SPECT对脑胶质瘤诊断及鉴别其恶性程度有效。该方法通过密切监测T/N比值,有助于判别肿瘤活性并确定患者预后。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验