Feasibility to Apply F18-Dopa Hybrid Mr-Pet Examination to Follow-Up of Patients with Neuroblastoma=氟18多巴磁振正子造影應用在神經母細胞瘤病患追蹤檢查的可行性研究

2017-08-012024-05-17https://scholars.lib.ntu.edu.tw/handle/123456789/673136摘要：本研究是基於氟18 多巴磁振正子整合造影與擴散影像的多參數影像應用在神經母細胞瘤病患的研究。神經母細胞瘤病患每3-6 個月就要接受常規追蹤檢查，其中包括氟18 多巴正子攝影電腦斷層掃描與磁振造影以監測腫瘤是否復發。電腦斷層定位的正子造影輻射劑量約為常規電腦斷層掃描的兩倍左右。因此有必要改用輻射劑量較低的磁振正子掃描作為追蹤工具，在合理降低輻射劑量原則下方便病童同時完成兩種追蹤檢查。本研究採用的氟18 多巴正子攝影電腦斷層掃描使用的氟18 多巴為台大醫院製造、並且已經上市。本研究第一年將對30位可在不需鎮靜麻醉而能配合接受氟18 多巴磁振正子整合造影掃描的神經母細胞瘤病患，在常規氟18 多巴正子攝影電腦斷層掃描之後，在不另外注射同位素的前提下，收集殘存訊號，接續配合施行磁振正子造影檢查，除了收集常規注射對比劑後的磁振造影檢查結果之外，同時針對腫瘤病灶施行擴散峰度影像與體素內不同調水分子運動影像檢查，此研究將比較正子攝影電腦斷層掃描與磁振正子掃描兩者的正子影像在病灶偵測與標準攝取值是否有差異，同時也採用擴散峰度影像與體素內不同調水分子運動影像檢查評估腫瘤組成特性。本研究第二年除了繼續收集另外30 例可配合接受氟18 多巴磁振正子整合造影掃描的神經母細胞瘤病患並進行後續每3-6 個月的例行影像追蹤之外，最後將以治療後追蹤檢查所呈現的腫瘤是否縮小或擴大作為做為比較標準，並根據第一年所得結果進行主因子分析與多變項分析，再進行羅吉斯迴歸分析，建立神經母細胞腫瘤在、正子影像衰減係數、擴散峰度與體素內不同調水分子運動影像檢查中的血流灌注係數、快慢擴散係數等等可能主成分顯著因子建立評估建立預測模型，並以第二年案例進行預測模型驗證；相關研究結果將作為臨床後續治療用藥方式與追蹤的參考。<br> Abstract: Patients with neuroblastoma have to receive regular follow-up examinationsincluding F18-DOPA PET and MR imaging to monitor recurrence of tumors. Theconventional CT-PET is about twice the radiation dosage of CT. It is reasonable toreplace CT-PET by MR-PET with reasonable decrease of ionizing radiation and letpatients receive MR and PET examinations simultaneously. F18-DOPA ismanufactured by NTUH and already on the market. During the first year of theproject, thirty cooperative neuroblastoma patients will be recruited to receiveF18-DOPA MR-PET examinations following regular CT-PET examinations withoutuse of additional isotopes. Residual proton density from F18-DOPA PET scan,contrast-enhanced MR, kurtosis and intravoxel incoherent motion images will beperformed. During the second year, another thirty cooperative patients withneuroblastoma will be recruited to receive F18-DOPA MR-PET examinationsfollowing regular CT-PET examinations. Residual proton density from F18-DOPAPET scan, kurtosis, perfusion fraction, fast and slow diffusion coefficients fromintravoxel incoherent motion images will be correlated with the regression orprogression on the follow-up images of neuroblastoma. Principal factor analysis,ANOVA will be performed first and followed by multinominal logistic regressionanalysis to develop a prediction model. The results of the study will be applied toevaluate the treatment efficacy, adjustment of treatment protocols and prediction of prognosis.氟18 多巴正子造影磁振正子造影神經母細胞瘤兒童擴散峰度影像體素內不同調水分子運動影像磁振造影Feasibility to Apply F18-Dopa Hybrid Mr-Pet Examination to Follow-Up of Patients with Neuroblastoma=氟18多巴磁振正子造影應用在神經母細胞瘤病患追蹤檢查的可行性研究