| 常鹏鹏,贾强,王深,郑薇,季艳会,谭建,张瑞国.基于全身动态辐射显像分析甲状腺乳头状癌首次131I治疗后放射性清除速率的影响因素[J].中国医学影像技术,2026,42(3):326~330 |
| 基于全身动态辐射显像分析甲状腺乳头状癌首次131I治疗后放射性清除速率的影响因素 |
| Analysis of impact factors of radioactive clearance rate after initial 131I therapy for papillary thyroid carcinoma using whole-body dynamic radiation imaging |
| 投稿时间：2025-12-15 修订日期：2026-02-10 |
| DOI：10.13929/j.issn.1003-3289.2026.03.002 |
| 中文关键词: 甲状腺肿瘤 癌,乳头状 碘放射性同位素 放射性核素显像 |
| 英文关键词:thyroid neoplasms carcinoma,papillary iodine radioisotopes radionuclide imaging |
| 基金项目:天津市科技计划项目(25JCYBJC00280)。 |
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| 中文摘要: |
| 目的 基于全身动态辐射显像技术分析甲状腺乳头状癌(PTC)首次131I治疗后放射性清除速率的影响因素。方法 回顾性收集130例首次接受131I治疗的PTC术后患者,以全身动态辐射监测系统测定治疗后2、24及48 h体内残留放射性活度,计算残留放射性活度变化率(RCR)。分别根据性别、131I剂量(≤4 440 MBq或＞4 440 MBq)、T分期(T1期或T2~T4期)、N分期(N0~N1a期或N1b期)、有无腺外侵犯、有无残留甲状腺组织(简称残甲)及复发风险(低-中危或高危)进行分组,比较组间服用131I后24 h、48 h RCR;以Pearson或Spearman分析各临床指标与服用131I后24 h、48 h RCR的相关性;采用多元线性回归分析筛选服用131I后24 h RCR的独立影响因素。结果 131I剂量≤4 440 MBq组服用131I后48 h RCR显著高于131I剂量＞4 440 MBq组(P=0.001);无残甲组服用131I后24 h RCR显著高于有残甲组(P=0.002)。身高、体表面积(BSA)及刺激性甲状腺球蛋白(sTg)均与服用131I后24 h RCR呈弱负相关(r=-0.199、-0.230、-0.180,P均＜0.05),而均与服用131I后48 h RCR无明显相关(P均＞0.05)。sTg水平及有无残甲均为服用131I后24 h RCR的独立影响因素(P均＜0.05)。结论 sTg水平及99TcmO-4甲状腺显像提示有无残甲均为PTC首次131I治疗后放射性清除速率的影响因素。 |
| 英文摘要: |
| Objective To analyze the impact factors of radioactive clearance rate after initial 131I therapy for papillary thyroid carcinoma (PTC) using whole-body dynamic radiation imaging technology. Methods A total of 130 postoperative PTC patients who underwent initial 131I therapy were retrospectively collected. Whole-body dynamic radiation monitoring system was used to measure the residual activity at 2, 24 and 48 h post-treatment, and the ratio of change of radioactivity (RCR) was calculated. Patients were stratified by gender, 131I dose (≤4 440 MBq or ＞4 440 MBq), T stage (T1 or T2—T4), N stage (N0—N1a or N1b), extrathyroidal extension or not, presence or absence of residual thyroid tissue and recurrence risk stratification (low-intermediate risk or high risk). Inter-group comparisons of RCR at 24 h and 48 h after 131I administration were performed. Pearson or Spearman correlation analyses were used to assess relationships between clinical parameters and RCR. Multiple linear regression analysis was conducted to identify independent impact factors of RCR 24 h after 131I administration. Results The 48 h RCR after 131I administration in 131I dose≤4 440 MBq group was higher than 131I dose＞4 440 MBq group (P=0.001). The 24 h RCR after 131I administration in non-residual thyroid group was higher than residual thyroid tissue group (P=0.002). Height, body surface area (BSA) and stimulated thyroglobulin (sTg) were all weakly and negatively correlated with 24 h RCR after 131I administration (r=-0.199, -0.230, and -0.180, all P＜0.05). No significant correlation was observed between each parameters and 48 h RCR after 131I administration (all P＞0.05). Both sTg level and presence or absence of residual thyroid were independent impact factors for 24 h RCR after 131I administration (both P＜0.05). Conclusion Both sTg level and 99TcmO-4 thyroid scintigraphy findings regarding residual thyroid tissue were significant determinants of radioiodine clearance rate following initial 131I therapy for PTC. |
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