Kumar A V S Anil, Kumar P G, Sampath Sangeetha, Suhag V
Senior Adviser (Medicine & Nuclear Medicine), Command Hospital (Southern Command), Pune 411040, India.
Assistant Professor, Department of Biochemistry, Armed Forces Medical College, Pune 411040, India.
Med J Armed Forces India. 2017 Jul;73(3):242-249. doi: 10.1016/j.mjafi.2017.01.001. Epub 2017 Feb 16.
Tumour seeking characteristics of TL-201 have been underutilized. The study was undertaken to evaluate the role of TL-201 scintigraphy in tumour imaging.
A total of 50 cases were studied over a period of 18 months (13 lymphomas, 11 breast carcinoma, 10 lung cancer, 6 of soft tissue sarcoma, 2 bone tumours and 4 cases each of thyroid and brain tumours). Thallium-201 chloride was injected IV in the dose range of 3-5 mCi. Imaging was done using Siemen's ECAM dual headed gamma camera. Mean tumour to background ratio (T/B ratio) was calculated for all the positive cases. Descriptive statistical analysis was carried out.
Findings revealed a sensitivity of 94.12%, specificity 87.5%, PPV 94.12%, NPV 87.50% and accuracy of 92% for TL-201 tumour imaging. The mean T/B ratio for the true positive cases at 10 min and at 3 h was 1.81 and 1.99 respectively, the difference being 0.18 ( value <0.001). Amongst them, the mean T/B ratios for low-grade tumours were 1.45 ± 0.32 at 10 min and 1.63 ± 0.38 after 3 h with difference of 0.176 ( < 0.001). For the high-grade tumours the ratios were 2.08 ± 0.35 and 2.26 ± 0.41 respectively with a difference of 0.186 ( < 0.001).
Thallium-201 scintigraphy is a useful tumour imaging modality in cases of thyroid, breast, brain, lung, soft tissue and bone tumours and lymphomas. A T/B ratio of 1.63 ± 0.38 in 3 h-delayed imaging is suggestive of low-grade tumours. For high-grade tumours a ratio of 2.26 ± 0.41 should be considered significant.
铊-201（TL-201）的肿瘤寻靶特性尚未得到充分利用。本研究旨在评估TL-201闪烁扫描在肿瘤成像中的作用。
在18个月的时间里共研究了50例患者（13例淋巴瘤、11例乳腺癌、10例肺癌、6例软组织肉瘤、2例骨肿瘤以及各4例甲状腺肿瘤和脑肿瘤）。静脉注射氯化铊-201，剂量范围为3 - 5毫居里。使用西门子ECAM双头γ相机进行成像。计算所有阳性病例的平均肿瘤与本底比值（T/B比值）。进行描述性统计分析。
结果显示，TL-201肿瘤成像的敏感性为94.12%，特异性为87.5%，阳性预测值为94.12%，阴性预测值为87.50%，准确性为92%。真阳性病例在10分钟和3小时时的平均T/B比值分别为1.81和1.99，差值为0.18（P值<0.001）。其中，低级别肿瘤在10分钟时的平均T/B比值为1.45±0.32，3小时后为1.63±0.38，差值为0.176（P<0.001）。高级别肿瘤的比值分别为2.08±0.35和2.26±0.41，差值为0.186（P<0.001）。
铊-201闪烁扫描在甲状腺、乳腺、脑、肺、软组织和骨肿瘤以及淋巴瘤的病例中是一种有用的肿瘤成像方式。3小时延迟成像时T/B比值为1.63±0.38提示低级别肿瘤。对于高级别肿瘤，比值为2.26±0.41应被视为有意义。
