[使用单光子发射计算机断层扫描的放射免疫闪烁显像：方法、问题与临床经验]

[Radioimmunoscintigraphy using SPECT: methodology, problems and clinical experiences].

作者信息

Bares R, Fass J, Truong S, Büll U, Schumpelick V

机构信息

Abteilung Nuklearmedizin des Klinikums der Rheinisch Westfälischen Technischen Hochschule Aachen, BRD.

出版信息

Nuklearmedizin. 1987 Oct;26(5):202-5.

PMID:3501573

Abstract

Radioimmunoscintigraphy (RIS) with 111In-and 131I-labelled monoclonal antibodies (MAbs) against CEA and/or CA 19-9 was performed in 83 patients with various gastrointestinal carcinomas. A total of 276 body regions could be examined. The results of planar scintigraphy and SPECT were compared intraindividually. Using 111In-labelled MAbs the sensitivity of RIS was significantly improved by SPECT (88.9 vs. 52.4% with planar scintigraphy, p less than 0.01). For 131I-labelled MAbs the effect was smaller (83.9 vs. 65.6% with planar scintigraphy, n.s.). This finding can be explained by different kinetics and biodistribution of the used MAb preparations. 111In-labelled MAbs with long whole-body retention and rapid blood clearance reveal ideal qualities for SPECT; on the other hand, the short whole-body retention of 131I-labelled MAbs leads to small count rates and therefore long counting times that make delayed SPECT unsuitable in clinical practice.

摘要

对83例患有各种胃肠道癌的患者进行了用铟-111和碘-131标记的抗癌胚抗原（CEA）和/或糖类抗原19-9（CA 19-9）单克隆抗体（MAb）的放射免疫闪烁显像（RIS）。总共可以检查276个身体部位。对平面闪烁显像和单光子发射计算机断层扫描（SPECT）的结果进行了个体内比较。使用铟-111标记的单克隆抗体时，SPECT显著提高了RIS的灵敏度（平面闪烁显像为52.4%，SPECT为88.9%，p<0.01）。对于碘-131标记的单克隆抗体，效果较小（平面闪烁显像为65.6%，SPECT为83.9%，无统计学意义）。这一发现可以用所用单克隆抗体制剂不同的动力学和生物分布来解释。全身滞留时间长且血液清除快的铟-111标记单克隆抗体显示出适合SPECT的理想特性；另一方面，碘-131标记单克隆抗体的全身滞留时间短导致计数率低，因此计数时间长，这使得延迟SPECT在临床实践中不适用。