untitled

SPECT/CT

1 SPECT/CT 317 0599-8602831 1321216408@qq.com 353000 317 / / () 1.1 1500 () 1.1.1 140 9.3% () / / / 1905 1995 8 23 3 600 16 10 1700 1600 95 6 7 2.5 103333 48359, 47 45 1 1 3

2014 1497 205 372 100 50 44 3 500 2 2016 3 18 11/2015-03/2016 201610105 3/10 [00127] 3 1.1.2 SPECT/CT 18 F 99m Tc 131 I 125 I 14 C 5 68 Ge 90 Sr 1-2 1-3 1-2 SPECT/CT Infinia with Hawkeye 1 2 3 4 1-3 18 F ECT 99m Tc ECT 131 I ECT 125 I 4

5 6 7 90 Sr 90 Sr 68 Ge SPECT/CT 14 C 253 1 SPECT/CT 18 F 99m Tc 131 I 125 I 14 C 68 Ge 90 Sr 1 GB 18871-2002 SPECT/CT 1.1.3 SPECT/CT 5 131 I 12m 131 I 125 I 1.5m 2 1-1 1-2 1-3 SPECT/CT 1-4 131 1 125 I 1-5 1.1.4 2013 1.1.5 1 SPECT/CT 2 131 I 125 I 5m 131 I 2 2 3 125 I 131 I 2 5

125 I CT CT DR MR 125 I 4 SPECT/CT SPECT/CT 1. 2. 3. 6

2 Bq 68 Ge 4.625 10 7 Bq/ / SPECT/CT V 90 Sr 2.05 10 9 / V / / / / / / n/s

3 Bq (Bq) 99m Tc 6.7610 7 1.69 10 10 18 F 0.8510 7 2.13 10 9 131 I 1.49 10 8 3.73 10 10 125 I 9.25 10 6 2.31 10 9 14 C 125 I / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / GB 18871-2002 8

4 (MeV) (A) / / / / / / / (Bq) / / / / / m 3 / / / / m 3 / / / / kg / / / kv (A) (n/s) / / / / / / / 3 H (Bq) (Bq) m 3 m 3 kg ()X X CT (kv (ma) SPECT/CT 140kV 2.5 CT 9

5 SPECT/CT ( ) 68 Ge 18 F 99m Tc 131 I 125 I 0.21m 3 <8.14Bq/L 52.5 m 3 <6.1510 5 Bq 131 I 18 F 99m Tc / / / 131 I 18 F 99m Tc 14 C / / 131 I / / / 90 Sr / / / 68 Ge / / / 1. mg/l mg/kg mg/m 3 kg 2.Bq/L Bq/kg Bq/m 3 Bq 10 10 10 131 I

6 6.1 (GB18871-2002) SPECT/CT 6-1 6-1 131 I 125 I 6-2 6-1 6-3 SPECT/CT 131 I 125 I 6-1 SPECT/CT 131 I 125 I 6.2 SPECT/CT SPECT/CT X 131 I 125 I 131 I 125 I SPECT/CT 6-2 SPECT/CT 6-2 SPECT/CT ECT / X

I-131 I-125 / / 6.3 (GB18871-2002) β 6.3.1 () 6.3.1.1 () 1mSv 5 1mSv 5mSv GB18871 0.1~0.3mSv 0.25mSv/a 6.3.1.2 5 20mSv 50mSv 5mSv/a 6.3.2 (GB18871-2002) 10 10ALI min 1 ALI min ALI min ALI (GB18466-2005) 2 12

β 10Bq/L 6.3.3 β (GB18871-2002) β 5-3 5-3 β β Bq/cm 2 40 4 4 0.4 6.3.4 (GB18871-2002) 131 I 400MBq( 11mCi) 6.3.5 C1 /Bq >4 10 9 2 10 7 ~ 4 10 9 ~2 10 7 1. 2. 13

7 12014 4 24 22002 10 28 32003 6 28 4 449 2005.12 5 2 2008.10 6 253 1998 7 3 2008.12 8 18 2011 9 2006 26 10 2005 62 11 562 2009.9 12 62 2005 1GB18871-2002 2(GB8999-1988) 3(HJ/T61-2001) 4GBZ133-2009 5GBZ120-2006 6 γ GB/T14583-93 7 X GBZ130-2013 8 X CT GBZ/T180-2006 9GB11930-2010 10GB8978-1996 1 1

8 8.1 8.1.1SPECT/CT 1 GE SPECT/CT SPECT CT SPECT/CT SPECT PET SPECT/CT 99m Tc 18 F 131 ISPECT/CT 8.1.1.1 SPECT Single-Photon Emission Computed Tomography 18 F 99m Tc 131 I 3 SPECT 3 6 SPECT/CT SPECT CT CT CT X X 15

8.1.1.2 SPECT/CT SPECT/CT 8.2 8-1 8-2 8-1 8-2 99m Tc SPECT/CT γ 99m Tc 0~3 10 ~30 8-1 β γ Γ (1) ALImin (2) KeV KeV (R m 2 (msv/bq) (MBq) /h Ci) Tc 6.02h 14188.5% 0.062 1.2 10-7 2 10-7 690 364(81.8%) 131 I 8.04 606(89.7%) 637(7.2%) 0.218 7.2 10-5 1.8 10-4 0.9 284(5.9%) 18 F 109min 633.5(96.7%) 511(200%) 0.536 4.2 10-7 5.2 10-7 215 14 C 5730 156100% 1.9 10-5 1.4 10-6 34.5 1 2ALImin ALI 16

8-2 Bq 125 I 60.1 125 I 1.4 10 7 4.5mm 0.8mm ~3.7 10 7 1~25 28KeV 1.7cm γ X 90 Sr 2.05 10 9 / 68 Ge 5.5x10 7 2 90 Sr 29.1 γ 288±6 19 293mm γ SPECT/CT 131 I SPECT/CT 18 F 109min β 8-1 γ 0.511MeV SPECT 8~10mCi 40 min1h 71min 14 C γ 14 C 125 I 125 I 125 I 4.5mm 8mm 125 I 0.05mm 28KeV 1.7cm 125 I 2s 25 125 I 1 25 125 I 9.25 10 8 Bq 90 Sr 90 Sr β X 17

68 Ge SPECT/CT SPECT/CT 1 1.5 2 68 Ge 1.1 10 8 Bq 99m Tc 131 I 18 F 8.3 8-3 8-4 8-3 / 131 I 131 I SPECT/CT SPECT/CT 18 F SPECT/CT SPECT/CT SPECT 99m Tc 125 I 68 Ge / / SPECT/CT SPECT/CT / 125 I CT SPECT/CT SPECT/CT 90 Sr / 14 C 14 C / 18

131 I 99m Tc 18 F 8-4 γ 1 1 I 1 1. 131 I 131 I 131 I 2. SPECT SPECT SPECT SPECT 99m Tc SPECT SPECT SPECT 18 F

14 C 90 Sr 125 I 14 C-UBT 14 C [ 14 C] 15min 90 Sr CT 3 1 2 20

131 I 99m Tc 18 F SPECT/CT 99m Tc 18 F 99m Tc 18 F SPECT/CT 2~10μCi 131 I 131 I5~10mCi 131 I 100mCi 131 I 7 10 14 C 8-5 8-5 SPECT/CT h (h) 99m Tc-MIBI 20mCi 0.25h2h 0.17h 99m Tc-MDP 25mCi 2h3h 0.33h 99m Tc-DTPA 4mCi 0h 0.33h 99m Tc-ECD 30mCi 0.5h 0.25h 99m Tc-DX 5mCi 0.083h2h 0.42h 99m Tc-MIBI 25mCi 1.5h 0.33h 99m Tc-EHIDA 5mCi 0.0832h 0.33h 99m Tc-O 4 10mCi 0.0831h 0.33h 99m Tc-RBC 10mCi 0h 1h 99m Tc-MAA 3mCi 0.083h 0.42h 99m Tc-O 4 5mCi 0h 0.5h 131 I 100 mci 0h 1h 18 F-FDG 18 F-FDG 515 mci 0.75h 1.18 h 8.3.3 131 I

131 I γ 131 I 26 Na 131 I2 10μCi) 2424h 131 I 131 I 131 I 8.3.4 Na 131 I510mCi) 8.3.5 TSH 30uIUml 100 mci 131 I 7 10 8.3.6 125 I 125 I CT CT CT CT CT 125 I CT CT CT 125 I 3 8.3.7 90 Sr 90 Sr 8.3.8 CT X X X 22

8.4 SPECT/CT SPECT/CT SPECT/CT X 131 I 131 I 125 I 8.5 SPECT/CT 8-6 8-6 / 250mm 3.0mmpb 8.0 mmpb 250mm 5.0mmpb 8.0 mmpb 250mm 5.0mmpb 8.0mmpb 10.0mmpb 300mm +4.0mmpb 2.0mmpb ( 6mmpb) 240mm 5.0mmpb 240mm 2.0mmpb 6.0mmpb 240mm 2.0mmpb 131 I 125 I 240mm 2.0mmpb 400mm 350mm 240mm 300mm 8.6 SPECT/CT 131 I 125 I 99m Tc 131 I 18 F 125 I γ 131 I 18 F 90 Sr β 23

CT X 24

9 2014 8 2 9-1 9-1 9-2 4 9-1 Xγ HD-2005 F001 2014 2 25 2015 2 24 1 2 3 4 5 0.107~0.162μSv/h SPECT/CT SPECT/CT 1. 2. 25

10 10.1 300 SPECT/CT 99m Tc SPECT CT SPECT/CT 1 SPECT/CT 10.2 SPECT/CT SPECT/CT 26

10.3 10.3.1 10.3.1.1 1 SPECT/CT 99m Tc 131 I 18 F γ 131 I 131 I γ 2 131 I SPECT 99m Tc 18 F γ 3 125 I 125 I 3 γ CT 125 I CT CT 125 I 28KeV 1.7cm 125 I 125 I 4 90 Sr β X 90 Sr β β X 5 6 β 27

β β 7 8 10.3.1.2 125 I CT CT 125 I 125 I 125 I 125 I 10.3.2 10.3.2.1 131 I 125 I 28

SPECT 99m Tc 18 F 131 I 10.3.2.2 W SPECT SPECT SPECT W 10-1 10-1 mci SPECT (h) W(Ci h/ ) (h) W(Ci h/) 576 20 0.25~2 2.88~23.04 0.17 1.96 1152 25 2~3 57.6~86.4 0.33 9.50 144 4 0 0 0.33 0.19 99m 96 5-10 0.083~0.6 0.04~0.58 0.42 0.2~0.4 Tc 42 15-20 0.5 0.32~0.42 0.5 0.32~0.42 100 20-25 1.5~2 3~5 0.33 0.66~0.83 50 10 0.25 0.13 0.92 0.46 2160 / / 63.97~115.57 / 13.92~13.76 131 I 96 5-15 0 0 1 0.48~1.44 18 F 720 8 0.75 4.32 1.18 6.8 7 10-1 SPECT/CT 99m Tc W 115.57 Ci h/spect/ct 99m Tc 13.76Ci h/ SPECT/CT 18 F W 4.32 Ci h/ SPECT/CT 18 F 6.8 Ci h/ 131 I W 0Ci h/ SPECT 1.44Ci h/ 99m Tc 131 I 18 F SPECT 29

10.3.2.3 He(mSv) 8.73 W Γ He T..9-1 2 r K 10-1W Ci h Γ R m 2 /h Ci 8-1 r m T T=1 T=1/4T=1/16 IAEA47-2006 K 70% 50% 1979 10-2~ 10-4 10-2 99m Tc SPECT/CT m K msv/a msv/a 0.3m 1/16 1.85 25cm 115.57 5 102 0.0023 0.25 0.3m 1/4 4.43 25cm 115.57 5 102 0.0016 0.25 10cm + 1/40 3 3mmpb 115.57 5 5 0.0070 0.25 30cm 0.3m 1/16 3.55 +4.0mmpb 13.76 20 5 0.0031 5 SPECT 6mmPb 1 4 0.3m 13.76 20 0.0233 5 SPECT 0.3m 1/16 3.25 5mmPb 13.76 8 0.0055 5 10cm + DSA 1 1 3 2mmpb 13.76 5 2 0.0828 5 DSA 1 3 10cm 13.76 5 0.1655 5 (1) SPECT (2) 2.3g/cm 3 (3) 8-6 2 (4) 30

10-3 18 F SPECT/CT m K msv/a msv/a 0.3m 1/16 1.85 25cm 4.32 8 0.0461 0.25 0.3m 1/4 4.43 25cm 4.32 8 0.0322 0.25 10cm + 1/40 3 3mmpb 4.32 2 1.5 0.0187 0.25 30cm 0.3m 1/16 3.55 +4.0mmpb 6.8 3 1.5 0.0351 5 SPECT 6mmPb 1 4 0.3m 6.8 2 0.9943 5 SPECT 0.3m 1/16 3.25 5mmPb 6.8 1.5 0.1255 5 10cm + DSA 1 1 3 2mmpb 6.8 2 1.5 1.1785 5 DSA 1 3 10cm 6.8 2 1.7677 5 (1) SPECT (2) 2.3g/cm 3 (3) 8-6 2 (4) 10-4 131 I SPECT/CT m K msv/a msv/a 0.3m 1/16 1.85 25cm 0 / 0 0.25 0.3m 1/4 4.43 25cm 0 / 0 0.25 10cm + 1/40 3 3mmpb 0 / 0 0.25 30cm 0.3m 1/16 3.55 +4.0mmpb 1.44 3.5 2 0.0019 5 SPECT 6mmPb 1 4 0.3m 1.44 3.5 0.0489 5 SPECT 0.3m 1/16 3.25 5mmPb 1.44 3 0.0054 5 10cm + DSA 1 1 3 2mmpb 1.44 2 1.5 0.1015 5 DSA 1 3 10cm 1.44 2 0.1523 5 (1) SPECT (2) 2.3g/cm 3 (3) 8-6 2 (4) 31

10.3.2.4 10-5 SPECT/CT 0.0484mSv/a 2.0855mSv/a 0.25mSv/a 5mSv/a 10-5 SPECT/CT 0.3m 0.3m 0.3m SPECT 0.3m SPECT 0.3m DSA 1 DSA (m) SPECT msv/a) 18 F 99m Tc 131 I (msv/a) 1/16 1.85 25cm 0.0461 0.0023 0 0.0484 1/4 4.43 25cm 0.0322 0.0016 0 0.0338 1/40 3 10cm + 3mmpb 0.0187 0.0070 0 0.0257 30cm 1/16 3.55 +4.0mmpb 0.0351 0.0031 0.0019 0.0401 1 4 6mmPb 0.9943 0.0233 0.0489 1.0665 1/16 3.25 5mmPb 0.1255 0.0055 0.0054 0.1364 1 3 10cm + 2mmpb 1.1785 0.0828 0.1015 1.3628 1 3 10cm 1.7677 0.1655 0.1523 2.0855 (msv/a) (1) SPECT (2) 2.3g/cm 3 (3) 8-6 2 10.3.3 β 8-1SPECT/CT 18 F 131 I β 10.3.4 0.25 5 32

99m Tc 18 F 131 I 125 I γ 10.3.4.1 SPECT 1 131 I 131 I SPECT A 3700MBq100 mci 10 76% 10 131 I A 100mCi 2-10/8 1-0.76=10.1mCi373 131 I 400MBq 131 I 2 99m Tc 99m Tc SPECT A 1110MBq30 mci 99m Tc γ Γ=0.062 R m 2 /h Ci AΓ=1.86mR m 2 /h 131 I 400MBq AΓ 2.4mR m 2 /h AΓ 99m Tc=0.78 AΓ 131 I 99m Tc 6h 131 I 8 γ 400 MBq 131 I 99m Tc 3 18 F A 370MBq10 mci 18 F 109min 80min 30% 80min 18 F A 10 mci 2-80/109 1-0.3=4.2 mci 18 F γ Γ=0.536R m 2 /h Ci AΓ=2.25mR m 2 /h 131 I 400MBq AΓ 2.4 mr m 2 /h AΓ 18 F=0.94 AΓ 131 I 18 F 109min 131 I 8 400 MBq 131 I 18 F 33

10.3.4.2 185 MBq(5 mci) 0.1%400 MBq 10.3.4.3 125 I 125 I A 925MBq25mCi 3 125 I A 25mCi 2-3/59.4 =24.14 mci 125 I γ Γ=0.07R m 2 /h Ci AΓ 125 I=1.69mR m 2 /h 131 I 400MBq AΓ 2.4mR m 2 /haγ 125 I=0.7AΓ 131 I 10.3.5 10-1 1 φ100 10mmpb 240mm 300mm φ110 DN110 6-1 6-2 2 SPECT 131 I 76% 99m Tc 18 F 30% 10-5 34

10-5 131 I 99m Tc 18 F SPECT 373.7GBq 76% =284.01GBq/=23.67GBq/ 1690.8GBq/ 30% =507.24GBq/=42.3GBq/ SPECT 213.1GBq/ 30% =63.93GBq/=5.3GBq/ 3 /10ALI min d 1 2630 0.0862 6.13 2.76 2.48 9.16 n V V i = V / nt i a i av av / n λ t ~ t dt i i i av i / ndtv 0 t ~ t dt Vdt 0 i i 1 a i 1 V 0 dt i 1 av i 0 dt ( a a ) V dt av / ndt i1 i 0 i i ( a a ) V dt av / ndt 0 i1 i 0 i n n V K 1.10-1 nv0 9-2V n n=8v=80 m 3 8 10m 3 80 m 3 V 0 m 3 /d m 3 /h 35

4 ( 131 I ) 131 I 18 F 99m Tc 131 I 131 I V 0 V 0 10-210-3 0.515m 3 5 SPECT/CT SPECT/CT2880 100250 12 SPECT/CT 0312 SPECTECT 1015L 3.8L 5-12L 8LSPECT/CT 96L 20L 116L 98 131 I2 2 45L 131 I90L0.09m 3 SPECT/CT 131 I210L0.21m 3 36

8.14Bq/L5.1310 4 Bq/ SPECT/CT 53 1 105 2 421 8 8-1 99m Tc 18 F 131 I 6.02 109 8.04 10 421 n 4 8 10Bq/L 8L 0.515m 3 10.3.6 GB1887-2002 C SPECT/CT 10-6 SPECT/CT 131 I 125 I 10-6 SPECT/CT Bq Bq 99m Tc 6.76 10 9 0.01 1 6.7610 7 18 F 0.85 10 9 0.01 1 0.8510 7 7.61 10 7 131 I 1.4910 9 0.1 1 1.4910 8 125 I 9.25 10 8 0.1 10 9.25 10 6 37

10-6 SPECT/CT 7.6110 7 Bq 131 I 1.4910 8 Bq 410 9 Bq GBZ120-2006 SPECT/CT GB18871-2002 10.3.4 18 2011 1 2 3 38

11 11.1 SPECT/CT 1 SPECT/CT 131I 125 I 125I SPECT 2 SPECT/CT 5 5 5 2 1 6 SPECT 4-5 γ β (3) SPECT/CT 20m (4) 3 39

2 131 1 1 99m Tc 18 F (5) GB11806-2004 SPECT/CT (GB18871-2002) 11.2 (l) SPECT/CT (2) SPECT/CT SPECT/CT 99m Tc 18 F 131 1 99m Tc 18 F 3 131 1 80 1000 40

(3) (4) SPECT/CT (5) β SPECT/CT SPECT/CT β (6) 2 41

γ (7) GB11806-2004 (8) SPECT/CT 300mm 4.0mmpb 6.0 mmpb CT 11.3 SPECT/CT 8-6 2 20cm 20cm 20cm (GB18871-2002) (0.25mSv) 11.4 (1) SPECT/CT γ β 42

γ β (2) SPECT/CT γ β l31 I β (3) SPECT/CT (4) (5) (6) 1. 2. 3. 43

11 11.5 (GBZ133-2009) (l) (2) (GB2133-2009) 2x10 7 Bq 150mm 44

8 3 1. 2. 45

12 12.1 3 5 12.2 18 2016 6 12.3 ( 18 2011 ) 1 31 1 12.3.1 1 /1 1 /1 12.3.2 46

SPECT/CT X-γ 3 3β β 3 4 β 4 12.4 7 8 SPECT 47

12.5 12-1 1 2 12-1 SPECT 125 I 125I 131 I (GB18871-2002) X-γ β SPECT/CT 3 SPECT/CT γ β 125 I 125 I 131 I γ β (GB18871-2002) GB18466-2005 2 α 1Bq/L β 10Bq/L 48

12-3 4 10 (GB18871-2002) GBZ133-2009 5 6 8L 0.515m 3 SPECT/CT (GB18871-2002) 131 I GBZ133-2009 8 80m 3 SPECT/CT 1 (GB18871-2002) GBZ133-2009 1. 2. 49

13 13.1 SPECT/CT (GB18871-2002)( 5mSv/a 0.25 msv/a)spect/ct 13.2 (1) 3 (2) (3) (4) SPECT/CT 1. 12 3. 4 2. 50

51

() () () 1 SPECT/CT 317 1 SPECT/CT 8510 ( ) 1500 ( ) 140 (%) 9.3 / / / / 0599-8602831 0591-83542992 353000 317 8 350011 2212 / / / / / / / ( ) (+) () (++) * * * * * * 0.25mSv/a 5mSv/a 1* 2(+)(-) 3 /; /; /; /; /; /; 52

( ) hm 2 Km 2 Km 2 % 53