摘要
目的：探讨18F-FDG显像对术前骨肉瘤患者化疗效果的评价意义。方法：临床诊断为骨肉瘤患者7例， 化疗前后分别接受两次18F-FDG显像。观察化疗前后两次图象特征，并进行半定量分析。利用公式（TNR1-TNR2）/TNR1计算获得化疗前后放射性计数率的变化率。经手术获得组织病理学肿瘤坏死率。结果： 7例患者化疗后与化疗前图象相比，病灶部位放射性摄取程度均有减低，化疗前后最大计数率有显著性差异（P<0.01），化疗前后平均计数率亦有显著性差异（P<0.01）。7例患者中，4例获得病理组织学坏死率疗效判定。3例肿瘤坏死率大于90％，1例肿瘤坏死率为80％，18F-FDG显像半定量分析，化疗前后计数率的变化率与坏死率具有正相关关系，（TNR1-TNR2）/TNR1max与坏死率的相关系数为0.94，（TNR1-TNR2）/TNR1average与坏死率的相关系数为0.84。结论：18F-FDG显像可用于判断骨肉瘤的化疗效果，半定量分析结果与病理组织学坏死率有正相关关系，有助于准确评估骨肉瘤的坏死率和化疗效果。
Abstract
Objective: To evaluate potential role of 18F-fluoro-2-deoxy-D-glucose(18F-FDG) in assessing chemotherapy response of primary osteosarcoma. Methods: Seven patients with osteosarcoma confirmed by pathology were examined with 18F-FDG imaging before and after chemotherapy. Two practiced nuclear medicine doctor observed the image and do the semi-quantitative analysis. Tumor to non-tumor radioactivity count ratios(TNR) was used. The radioactivity count variance ratio before and after chemotherapy obtained by using formula(TNR1-TNR2)/TNR1. The histopathological tumor necrosis were obtained by surgery. Result: The radioactivity count before and after chemotherapy(TNR1max and TNR2max；TNR1average and TNR2average) had significant difference(P<0.05). Four of the 7 patients got histopathological tumor necrosis, which had a significant correlation to the radioactivity count variance ratio. The correlation coefficient of (TNR1-TNR2)/TNR1max and (TNR1-TNR2)/TNR1average with the tumor necrosis were 0.94 and 0.84 respectively. Conclusion: 18F-FDG imaging can be used to assess the chemotherapy response of osteosarcoma noninvasively.The semi-quantitative analysis which has consistency with the histopathological tumor necrosis is helpful in evaluating response of osteosarcoma to chemotherapy.
关键词
骨肉瘤 /
体层摄影术 /
发射型计算机 /
单光子 /
药物疗法
Key words
Osteosarcoma /
Tomography /
emission-computed /
single-photon /
Drug therapy
冯 瑾;彭京京;刘洪洪;杨 芳;牛晓辉.
18F-FDG显像对骨肉瘤化疗效果评价的初步研究[J]. 中国临床医学影像杂志. 2010, 21(9): 638-641
FENG Jin;PENG Jing-jing;LIU Hong-hong;YANG Fang;NIU Xiao-hui.
Response of osteosarcoma to chemotherapy evaluated by 18F-FDG imaging[J]. Journal of China Clinic Medical Imaging. 2010, 21(9): 638-641
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