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Một số ứng dụng công nghệ bức xạ trong chẩn đoán và điều trị bệnh ung thư

Một số ứng dụng công nghệ bức xạ trong chẩn đoán và điều trị bệnh ung thư

31/03/2020 22:13:03 | 0 binh luận

Applications ofradiation technology in the diagnosis and treatment of cancer SUMMARY: Incidence and mortality rates of cancer are currently on the top of disease pattern and the number is increasing and increasing worldwide. The impact of screening program for early diagnosis has been proved their important roles in the war against cancer because it helps increase the cure rates, decrease the mortality and morbidity rates, and therefore, reduce the economic-social burden. Advances in diagnostic imaging techniques, especially the hybrid imaging (Xray and Nuclear Medicine) such as PET/CT, SPECT/CT, PET/MRI, is important in accurate staging and these help choose the optimized treatment options to prolong survival while improve the quality of life. The treatment outcomes of cancer has certain remarkable advances based on variety of researches to modify, promote and strengthen the traditional treatments (surgery-chemotherapy-radiation) such as laparoscopic surgery, combined chemo-regimens, intensity modulated radiation therapy, volumetric modulated arc therapy, stereotactic radiation therapy, radiosurgery, PET/CT simulation, radioactive seeds implant, selective internal radiation therapy, intraoperative radiation therapy, ... as well as the emerge of new methods such as targeted therapy, immunotherapy, radioimmunotherapy, proton therapy and heavy ion. Treatment of cancer is now becoming the “invidualized treatment” with advances in biochemistry and histophathology that helps identify characteristics of tumors individually . To achieve the most optimal outcomes, cancer should be approached by a mulitprofessional team including
Nghiên cứu ảnh hưởng của I-131 liều 100 MCI tới tủy xương trong điều trị ung thư tuyến giáp thể biệt hóa đã phẩu thuật

Nghiên cứu ảnh hưởng của I-131 liều 100 MCI tới tủy xương trong điều trị ung thư tuyến giáp thể biệt hóa đã phẩu thuật

03/04/2020 09:22:13 | 0 binh luận

Research effects of 100 mCi dose Iodine- 131 on bone marrowin therapy for operated differentiated thyroid carcinoma SUMMARY: Researching into the effects of 100 mCi dose I-131 on bone marrow of 31 operated differentiated thyroid carcinoma patients, after 03 months of I-131 therapy, through the characteristics of peripheral blood cells and hematopoietic precursors of bone marrow, comparing with prior to I-131 therapy, the results showed that: On the peripheral blood circulation: Lymphocyte and thrombocyte counts were decreased obviously (p< 0.05). However, the mean values of lymphocyte and thrombocyte counts still belong to normal reference values; Erythrocyte lineage has not yet had affected signs of I-131 at dose of 100 mCi, that causes the decresae in erythrocyte count and hemoglobin concentration; The increase of patient percentage with unusual cytoplasm of Neutrophils (hypogranular neutrophil or the presence of vacuoles in cytoplasm) (p= 0.01); The increase of patient percentage with large thrombocyte in dimension (p= 0.038). On bone marrow: bone marrow cell counts were decreased (p= 0.0001). However, the mean value of bone marrow cell counts still belong to normal reference value; The decrease of patient percentage found lymphocytic precursors and Basophilic meakaryocytes (p < 0.001); The increase of patient percentage found lymphocytes with cleaved nucleus (p= 0.01); The increase of patient percentage with unusual cytoplasm of granulocytic precursors (decreased azurophilic granules or the presence of vacuoles in cytoplasms) (p < 0.05). Key words: Eeffects of 100 mCi dose Iodine- 131 on bone marrow.
Chỉ định liều 131I trong điều trị bệnh nhân Basedow

Chỉ định liều 131I trong điều trị bệnh nhân Basedow

02/04/2020 22:36:59 | 0 binh luận

Dose indication treated by iodine-131 for Grave’s patients SUMMARY: 543 Grave’s patients were treated by iodine-131. The treatment dose for patients were variable from 70 to 170 μCi/1g thyroid mass, depending on the value of thyroid volume and iodine uptake of thyroid. Follow up 6-24 months after treatment showed that: with appropriate dose indication had a significant reduction of the rate of hypothyroidism and hyperthyroidism.
Gía trị của 18FDG PET/CT và CT ở bệnh nhân ung thư tuyến giáp biệt hóa có nồng độ Thyroglobulin huyết thanh cao và xạ hình toàn thân với 131I âm tính

Gía trị của 18FDG PET/CT và CT ở bệnh nhân ung thư tuyến giáp biệt hóa có nồng độ Thyroglobulin huyết thanh cao và xạ hình toàn thân với 131I âm tính

02/04/2020 21:23:58 | 0 binh luận

Value of PET /CT and diagnostic CT scan in differentiated thyroid carcinoma patients with high serum thyroglobulin and negative 131I whole body scan SUMMARY: Objective: to determine value of FDG-PET/CT and diagnostic CT scan in post-surgical differentiated thyroid carcinoma patients with high serum thyroglobulin and negative 131I whole body scan. Patients and method: We performed FDG-PET/CT and diagnostic CT scan in 49 post-surgical differentiated thyroid carcinoma patients with high serum thyroglobulin and negative 131I whole body scan who already underwent 131I therapy in Department of Nuclear Medicine, 108 Central Military Hospital. Results: 41 lesions detected in 29/49 patients (59.2%) with positive PET/CT scan compared to only 20 lesions 18/49 patients (36.7%) detected on positive CT scan. The Sn, Ac and NPV of FDG-PET/CT were 83.9%, 83.7% and 75% higher than those of CT (51.6%, 65.3% and 51.6%, respectively). Sp and PPV of FDG-PET/ CT (83.3% and 89.7%, respectively) were similar to those of CT (88.9%). SUVmax thresholds with good diagnostic value were 4.5 ( Sn 84.6%, Sp 66.7%) and 5.0 ( Sn 65.3%, Sp 100%). FDG-PET/CT had altered treatment plan in 25/49 patients (51.2%). Conclusion: FDG-PET/CT is superior than CT in detecting reccurent/metastatic lesions in post-surgical differentiated thyroid carcinoma patients with high serum thyroglobulin and negative 131I whole body scan. Key words: FDG PET/CT, CT, differentiated thyroid carcinoma
Nghiên cứu giá trị tiên lượng của xạ hình SPECT tưới máu cơ tim ở bệnh nhân sau nhồi máu cơ tim

Nghiên cứu giá trị tiên lượng của xạ hình SPECT tưới máu cơ tim ở bệnh nhân sau nhồi máu cơ tim

02/04/2020 21:13:45 | 0 binh luận

Evaluation the prognostic of SPECT in post myocardial infarct SUMMARY: Aims: The purpose of our study was to evaluate the prognostic value of characteristics of defects in Tc99m-sestamibi gated SPECT myocardial perfusion imaging (MPI) in post-MI patients. Subjects and methods: 116 post-myocardial infarction (MI) patients were underwent gated SPECT in Nuclear Medicine Department, 108 Central Military Hospital from March 2007 to May 2010. Mean follow-up time was 23.27 ± 9,9 months. Results: The reversible perfusion defects had higher rate of patients with unstable angina (92.1% vs 76.9%, p<0.05) and revascularization (95.8% vs 72.1%, p<0.01), respectively. The fixed defect had higher rate of patients with congestive heart failure compared to patient group without congestive heart failure (47.2% vs 6.1%, p<0.001). In patients with unstable angina (UA) and/or recurrent MI, severe and large defects were significant highger than that of patients without UA and/or recurrent MI (p<0.05). In congestive heart failure (CHF) patients, severe and large defects were 97.1% and 76.8% in comparison with 88.2% and 70.7% respectively (p < 0.05). In fatal patient group, 100% had large defects compared to 72% in non-fatal MI patients. SSS and SRS were higher in post-MI patient with coronary events compared to those without coronary events (18.17 ± 5.3 vs 13.5 ± 3.65, p<0.001 and 14.77 ± 5.46 vs 11.04 ± 3.58, p < 0.01). Conclusions: the characteristics of myocardial perfusion defect on MPI have prognostic value in post-MI patients.
Tương quan cao về mức độ hấp thu 2-deoxy-2-F18-fluoro-D-glucose (FDG) qua trung gian glucose transporter type 1 giữa khối u nguyên phát và hạch di căn tại chổ tại vùng trong ung thư phổi không tế bào nhỏ

Tương quan cao về mức độ hấp thu 2-deoxy-2-F18-fluoro-D-glucose (FDG) qua trung gian glucose transporter type 1 giữa khối u nguyên phát và hạch di căn tại chổ tại vùng trong ung thư phổi không tế bào nhỏ

02/04/2020 18:02:52 | 0 binh luận

High correlations between primary tumours and locoregional metastatic lymph nodes in non-small-cell lung cancer with respect to glucose transporter type 1-mediated 2-deoxy-2-F18- fluoro-D-glucose uptake SUMMARY: The purpose of the study was to investigate whether glucose transporter type 1 (Glut-1) mediated 2-deoxy-2-F18- fluoro-D-glucose (FDG) uptake of primary tumour is related to the likelihood of malignancy involvement in loco-regional lymph nodes (LNs) in 126 non-small-cell lung cancer (NSCLC) patients (M:F = 103:23, age = 65 ± 9.7 years). Maximum standardized uptake values (maxSUV) and Glut-1 expression levels (determined by PET and immunostaining, respectively) of primary tumours and PET positive loco-regional LNs were compared. Significant correlations were found between malignant LNs and primary tumours with respect to maxSUV (r = 0.6451, p < 0.0001), %Glut-1 expression (r = 0.8341, p < 0.0001) and Glut-1 staining intensity (p = 0.827, p < 0.0001). The areaunder- curve value for LN differentiation using lymph node maxSUV was significantly higher in patients with a primary tumour maxSUV of >6 (AUC = 0.775, p = 0.0001). High correlations between the primary tumours and metastatic LNs in NSCLC with respect to the Glut-1 mediated FDG uptake may be useful for mediastinal LN discrimination by FDG-PET. Keywords: Non-small-cell lung cancer, FDG-PET, Lymph node, Glucose transporter.
Nghiên cứu đặc điểm tổn thương xương trên xạ hình xương toàn thân  99mTc-MDP ở bệnh nhân ung thư vú, phổi và tiền liệt tuyến

Nghiên cứu đặc điểm tổn thương xương trên xạ hình xương toàn thân 99mTc-MDP ở bệnh nhân ung thư vú, phổi và tiền liệt tuyến

02/04/2020 17:57:00 | 0 binh luận

Detection of bone metastases on breast cancer , lung cancer and prostate cancer patients by spect 99mTc – MDP inmaging SUMMARY: Background: Skeletal scintigraphy is a good modality for detecting bone metastasis. It can provide a whole view of skeletal system and has a high sensitivity. Method and Material: 99mTc – MDP bone scan for 108 patients with different stage cancer of Breast, Lung or Prostate, with or without clinical syndrome of bone metastases. Result: Bone metastases were detected on 73 studied patients (69.4%). Almost were multifoci asymmetric lesions, with increased uptake of radiophamatical activity (93.3%). The most common site of bone metastases were spine, pelvis (hip) and ribs. Conclusion: Almost imaging of bone metastases in bone scan were multifoci asymmetric lesions with increased uptake of radiophamatical activity (93.3%). The most common site of bone metastases are spine, pelvis (hip) and ribs. Key words: Bone metastases, Bone scan 99mTc- MDP.
Bước đầu đánh giá vai trò của FDG-PET/CT trong chẩn đoán và lập kế hoạch xạ trị ung thư vòm mũi họng

Bước đầu đánh giá vai trò của FDG-PET/CT trong chẩn đoán và lập kế hoạch xạ trị ung thư vòm mũi họng

02/04/2020 17:52:56 | 0 binh luận

Initial evaluation of the role of FDG -PET /CT in diagnosis and radiotherapy planification of nasopharyngeal carcinoma (NPC) SUMMARY: NPC (cavum) is a common disease in the world (1% world population according to UICC) and one of leading causes of death in South China as well as in most of ASEAN countries. PET/ CT (Positron Emission Tomography/Computed Tomography) is a modern imaging modality, playing an important role in management of NPC. Applications of FDG-PET/CT in NPC are diagnosis, staging, restaging for recurrence, monitoring therapeutic response and radiotherapy planning. Purposes: Initial evaluation of role of PET/CT in diagnosis and radiotherapy planning for 20 NPC patients (cavum tumor). Objects and research method: 20 patients with determined diagnosis of NPC with anapathological results, received PET/CT in Nuclear medicine and Oncology Center, Bach Mai hospital for diagnosing, staging and emulating radiotherapy plan from July 2010 to January 2011. Results: 1. FDG-PET/CT is very valuable in diagnosing and staging NPC including detection of primary tumor in metastasic patients with unknown origin; Importance of FDG uptake (SUV value) is high at cavum (mean SUV = 11.83), at metastatic ganglions (mean SUV= 8.37) helping detection, staging modified in 38.9% patients, modifying treatment way as well as better prognosing. 2. FDG-PET/CT is usefull in planning NPC radiotherapy by helping exactly BTV, without omission of regional ganglions, modifying volume of radiotherapy in 80% patients in compared with conventional emulation by CT, reducing volume of radiotherapy in 60% patients, limiting complications due to radiation. Mean GVT-PET volume is about 92.3 cm3 in compared with GTV-CT (128.4 cm3). Conclusion: Using FDG-PET/CT is a highly effective and safe technics in diagnosing and emulating radiotherapy plans for NPC patients. Key words: PET/CT, diagnosing, emulating, radiotherapy, NPC
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