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目的评价９９Ｔｃｍｔｅｔｒｏｆｏｓｍｉｎ（ＴＦ）显像在肺癌诊断中的临床意义。方法用９９ＴｃｍＴＦ对１６例已证实的肺癌患者进行平面和断层显像研究。所有病人均行ＣＴ和１８Ｆ脱氧葡萄糖（ＦＤＧ）ＰＥＴ检查。用感兴趣区分析法对９９ＴｃｍＴＦ和１８ＦＦＤＧ图像进行定性及定量分析，计算肿瘤及非肿瘤内放射性比。结果ＣＴ共检出１４个肿瘤病灶，２个因胸膜广泛渗出未能检出。此外８例患者，ＣＴ显示了２１个受累纵隔淋巴结（＞１５ｃｍ）。９９ＴｃｍＴＦ平面和断层显像诊断肺癌病灶的灵敏度分别为８８％（１４／１６）和９４％（１５／１６）。所有肺癌病灶均有１８ＦＦＤＧ摄取增高。定量分析示１８ＦＦＤＧ在肺癌的摄取明显高于９９ＴｃｍＴＦ（４５２±１５０与１５５±０３０，ｔ＝４０２９，Ｐ＜０００１）。ＣＴ和病理活检示中心坏死的２个肺癌病灶，９９ＴｃｍＴＦ和１８ＦＦＤＧ显像均示肿瘤中心放射性缺损。对于异常淋巴结，平面显像只发现３例病人中的４个淋巴结，而ＳＰＥＣＴ显像检出１７个淋巴结有９９ＴｃｍＴＦ异常摄取。ＣＴ所示的２１个异常淋巴结，１８ＦＦＤＧ摄取均增高。结论９９ＴｃｍＴＦ显像用于肺癌患者的诊断有其临床?
Objective To evaluate the clinical significance of 99Tcm-tetrofosmin (TF) imaging in the diagnosis of lung cancer. Methods Sixty-two confirmed lung cancer patients underwent planar and tomographic imaging using 99Tcm-TF. All patients underwent CT and 18F deoxyglucose (FDG) PET. The 99Tcm-TF and 18F-FDG images were qualitatively and quantitatively analyzed using the region-of-interest analysis to calculate tumor and non-tumor radioactivity ratios. Results A total of 14 tumor lesions were detected on CT and 2 were not detected due to extensive pleural effusion. In 8 patients, CT showed 21 mediastinal lymph nodes (>15cm). The sensitivity of 99Tcm-TF plane and CT imaging in the diagnosis of lung cancer lesions was 88% (14/16) and 94% (15/16), respectively. All lung cancer lesions have increased 18F-FDG uptake. Quantitative analysis showed that the uptake of 18FFDG in lung cancer was significantly higher than that of 99TcmTF (452±150 vs. 155±030, t=4029, P<0001). CT and pathological biopsy showed two neoplastic lesions with central necrosis. 99Tcm TF and 18FFDG imaging showed tumor center radioactivity defect. For abnormal lymph nodes, only 4 out of 3 patients were found by planar imaging, and abnormal uptake of 99 Tcm TF was detected in 17 lymph nodes by SPECT imaging. Twenty-one abnormal lymph nodes shown by CT showed increased 18F-FDG uptake. Conclusion 99Tcm-TF imaging has clinical application in the diagnosis of lung cancer.