Clinical nuclear madicine by using small high resolution gamma camera in head and neck region

用于放射引导手术的小型半导体伽马相机（临床型和试验型）比传统的闪烁相机（CSC）提供更好的能量分辨率。图像由直径为1 mm的聚乙烯管制成，高20 mm的“S”形影体，填充30MBq Tc-99m，直接放置在每个相机的表面，采集时间为2秒。临床型和试验型获得的图像比CSC获得的图像清晰得多，因此临床型和试验型具有高灵敏度和高空间分辨率。临床型的表现与试验型相似。在机构审查委员会批准研究方案并获得所有患者的知情同意后，进行了初步临床研究。对127例头颈部疾病患者（恶性肿瘤72例，良性肿瘤4例，唾液腺疾病6例，唾液石5例，口干症7例，干燥综合征4例，骨瘤10例，脂肪瘤7例，颞下颌关节关节病7例，其他疾病11例）采用伽玛照相机和CSC（骨显像93例）进行显像。25例患者行唾液腺显像，9例患者行淋巴显像。初步的临床研究成功地利用伽玛相机在短采集时间内成像。伽马照相机比传统的闪烁照相机提供了更好的图像。伽玛相机拍摄了15、30和60年代的图像，30和60年代的伽玛相机图像清楚地显示了乳腺癌（滨松大学医学院和庆应义塾大学医学院）、食管癌（庆应义塾大学医学院）、喉癌（庆应义塾大学医学院）、牙龈癌（日本牙科大学）、舌癌（日本牙科大学）和刺状细胞癌（新泻癌症中心医院）可以通过伽玛相机清晰地看到。在国际临床试验研究中，伽玛相机的图像分别拍摄了15秒和30秒，30秒伽玛相机的图像清晰地显示了患者的淋巴结（美国约翰韦恩癌症研究所）。伽玛相机在分离前哨淋巴结活检方面可能比目前的技术更有优势。这种相机的另一个潜在应用是诊断，特别是位于组织或器官（如甲状腺、颌骨、面部骨骼和关节）中的小的、浅表病变。少

Small semiconductor gamma cameras(clinical type and trial type) for radioguided surgery provided better energy resolution than a conventional scintillation camera (CSC). Images obtained form a 20-mm-tall "S" figure phantom made from a 1-mm-diameter polyethylene tube and filled with 30MBq Tc-99m, that was placed directly on the surfacee of each camera with a 2-s acquisition time. The images obtained by clinical type and trial type were much clearer than that obtained with a CSC, and so clinical type and trial type achieve high sensitiveity and high spatial resolution. clinical type's performance is similar equal to trial type's it.Preliminary clinical studies were performed, after institutional review boards approved the study protocol and informed consent was obtained from all patients. 127 patients with head and neck diseases (72 with malignant tumor, 4 with benign tumors, 6 with diseases of salivary gland, 5 with sialolith, 7 with xerostomia, 4 with sjogren syndrome, 10 with osteomye … More litis, 7 with arthrosis of temporomandibular joint and 11 with another diseases) underwent scintigraphy using the gamma camera and the CSC (bone scintigraphy were performed in 93 patients, salivary gland scintigraphy were performed in 25 patiens and lymph scintigraphy were performed in 9 patiens). Preliminary clinical studies were successful in imaging in short acquisition time by using the gamma cameras. Gamma cameras provided better images than conventional scintillation camera. Gamma cameras images were taken for 15, 30 and 60 s, 30- and 60-s gamma cameras images clearly showed lymph nodes of patients who had breast cancer (by Hamamatsu University School of Medicine and Keio University School of Medicine), Esophageal cancer (by Keio University School of Medicine), laryngeal cancer (by Keio University School of Medicine), carcinoma of gingival (The Nippon Dental University), carcinoma of tongue (The Nippon Dental University) and prickle cell carcinoma (Niigata Cancer center Hospital) could be clearly visualized by the gamma cameras. In the International Clinical Trial study, Gamma camera's images were taken for 15 and 30 s, 30-s gamma camera's images showed clearly lymph nodes of patients (by John Wayne Cancer Institute, USA). The Gamma camera may offer advantage over current techniques for isolating sentinel lymph nodes for biopsy. A further potential application for this camera is in diagnosis, particularly of small, superficiall lesions situated in tissues or organs such as the thyroid gland, jaws facial bones and joints. Less