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目的:探讨~(99m)Tc标记肼基烟酰胺奥曲肽类似物(~(99m)Tc-hydrazinonicotinyl-Tyr3-octreotide,~(99m)Tc-HYNICTOC)显像探测结直肠神经内分泌肿瘤(neuroendocrine neoplasm,NEN)的价值。方法:对122例行~(99m)Tc-HYNIC-TOC显像的结直肠NEN患者进行回顾性分析,其中原发灶位于阑尾26例、直肠90例、乙状结肠3例、横结肠2例、降结肠1例。静脉注射370~555 MBq~(99m)Tc-HYNIC-TOC 2 h后,全身平面显像,随后行腹盆部SPECT/CT断层显像,对各个病灶进行图像分析,测量靶/非靶放射性计数比值(target/non-target,T/NT),病灶判断以临床治疗和随访结果为金标准。结果:~(99m)Tc-HYNICTOC对结直肠NEN的灵敏度、特异度和准确率分别为93.2%、97.4%和95.9%。病灶检出率为89.2%(199/223),阳性病灶T/NT平均值为14.3±9.7(1.3~37.9,n=199),G1与G3、G2与G3级阳性率比较差异均有统计学意义(χ~2=10.906,P=0.001;χ~2=19.775,P<0.001)。此外,SPECT/CT断层配合全身平面显像可更加准确地发现病灶,对结直肠NEN患者术前评估及疗效评价均有较好的应用价值。结论:~(99m)Tc-HYNIC-TOC显像可准确、灵敏地探测结直肠NEN。
OBJECTIVE: To investigate the diagnostic value of ~ (99m) Tc-labeled hydrazine nicotinamide octreotide analogue (~ (99m) Tc-hydrazinonicotinyl-Tyr3-octreotide, ~ (99m) Tc-HYNICTOC) for the detection of neuroendocrine neoplasm )the value of. Methods: Retrospective analysis was performed on 122 patients with ~ (99m) Tc-HYNIC-TOC imaging of colorectal NEN. The primary tumor was located in the appendix in 26 cases, rectum in 90 cases, sigmoid colon in 3 cases, transverse colon in 2 cases, descending colon 1 case. After intravenous injection of 370-555 MBq 99m Tc-HYNIC-TOC for 2 h, whole-body imaging was performed and SPECT / CT imaging of the abdomen was performed. Image analysis of each lesion was performed to measure the target / non-target radioactivity count Ratio (target / non-target, T / NT), the lesion to determine the clinical treatment and follow-up results as the gold standard. RESULTS: The sensitivity, specificity and accuracy of ~ (99m) Tc-HYNICTOC for colorectal NEN were 93.2%, 97.4% and 95.9%, respectively. The positive rate of lesions was 89.2% (199/223) and the positive rate of T / NT was 14.3 ± 9.7 (1.3-37.9, n = 199). The positive rates of G1, G3, G2 and G3 were statistically different Significance (χ ~ 2 = 10.906, P = 0.001; χ ~ 2 = 19.775, P <0.001). In addition, SPECT / CT tomography combined with whole-body planar imaging can more accurately detect the lesion, which has a good value in preoperative evaluation and curative effect evaluation of colorectal NEN. Conclusion: ~ (99m) Tc-HYNIC-TOC imaging can accurately and sensitively detect colorectal NEN.