~（99m）Tc-MIBI動注投与による転移性肝癌に対する肝動注化学療法の治療効果予測

摘要

肝動注1)ザレバーを留置した転移性肝癌患者11例を対象に,肝動注化学療法治療前に（99m）~Tc-MIBIを動注しSPECTを施行し,集積程度と治療効果について検討した. SPECTの早期像と後期像を撮像し,定量指標としてearly ratio (ER), delayed ratio (DR), washout rate (WR), retention index (RI)を算出した.治療効果判定は肝動注化学療法治療前後のCTより行い,有効,不変,悪化の各群に分類した.有効群では~(99m)T~c-MIBIのER,DRは悪化群と比べ高値を示し,明らかな関連性を示した. wR,RIは各群間での関連性は乏しかった.転移性肝癌に対する~(99m)Tc-MIBI動注SPECTを用いたER,DRの評価は,肝動注化学療法の治療効果予測に有用であると考えられた.SPECT was performed in 11 patients with meta-static hepatic cancer by intraarterial infusion of ~(99m)Tc-MIBI before hepatic arterial chemotherapy was started, and the degree of accumulation and clinical efficacy were compared. Early and delayed SPECT images were obtained and various parameters were calculated, including early ratio (ER), delayed ratio (DR), washout rate (WR), and retention index (RI). Judgement of clinical efficacy was made by CT before and after hepatic arterial chemotherapy and was classified as effective, unchanged, and progressive groups. The mean values of ER and DR in the effective group were higher than those in the progressive group. No relationships were noted among the WR and RI values of the groups. The assessment of ER and DR using ~(99m)Tc-MIBI intraarterial SPECT is considered to be useful for prediction of the clinical efficacy of hepatic arterial chemotherapy for metastatic hepatic cancer.