The volumetric methods in the lesions for radioisotope therapy

对病变功能体积的估计是了解疾病严重程度的重要因素。我们一直试图开发一种简便的方法来测定积累了放射性药物的器官或病变的功能体积。在基础研究之后进行容积分析的临床评价，以估计I-131治疗Graves甲亢患者的甲状腺体积，并确定心脏病患者的心脏射血分数。本研究纳入57例Graves病甲状腺功能亢进患者，并对其治疗效果进行比较。87%的患者经Tc-99m高技术酸盐显像计算甲状腺体积低于50g。将患者按吸收剂量、低剂量（50 ~ 60gy）、中剂量（60 ~ 80gy）、高剂量（80 ~ 90gy）随机分为3组。并评价了吸收剂量与治疗效果的关系。85%接受低剂量治疗的患者在I-131治疗1年后显示甲状腺功能正常。高剂量组甲减发生率增高。低剂量治疗可使Graves甲状腺毒症患者发展为甲状腺功能亢进。使用RI技术的体积法是治疗I-131的潜在应用。对27例心脏病患者采用心池容积法测定心脏射血分数的方法进行了评价。采用ECG门控SPECT结合QGS程序测量心室舒张末容积和收缩末容积，并与冠状动脉造影结果进行比较。左心室射血分数与心导管测得的水平有良好的相关性（y = 1.27X+9.25, r = 0.962）。心电门控SPECT容积法结合QGS程序是一种很有前途的心功能测量方法。

The estimation of functioning volume in the lesion is an important factor to know the severity of illness. We had been tried to develop the easy method of functioning volume in the organ or lesion tht accumulated radiopharmaceuticals. Clinical evaluation of volumetric analysis following the basic study was performed to estimate the thyroid volume for I-131 therapy in the patients with Graves' hyperthyroidism and to decide the cardiac ejection fraction in the patients with cardiac disease. Of the 57 patients with hyperthyroidism due to Graves' disease who were treated with I-131 was included in this study and compared with the therapeutic effects. The calculated thyroid volume became under 50gram in 87% of patients by scintigraphy with Tc-99m pertechnetate. The patients were classified in three groups according to the absorbed dose, low dose (50-60Gy), middle does (60-80Gy), and high dose (80-90Gy) randomly. And, the relationship between the absorbed dose and therapeutic effect was evaluated. 85% of patiesnts treated with low dose showed euthyroid at 1 year after I-131 therapy. The rate of hypothyroidism was increased in the patients treated with high dose. Low dose therapy was thought to be adequate for leading the patients of Graves' thyrotoxicosis to euthyroidism. The volumetric method by using RI technique was potential use for therapy with I-131. The methodology of heart pool volume for the measurement of cardiac ejection fraction was evaluated in 27 patients with heart disease. The ECG gated SPECT compined with QGS program was used for the measurement of the end diastolic volume and end systolic volume of ventricle and compared with the results of coronary angiongraphy. The ejection fractions of left ventricle was well correlated with the levels measured by cardiac catheterization (y = 1.27X+9.25, r = 0.962). It was recognized that the volumetric method by ECG gated SPECT combined with QGS program become a promising method of cadiac function.