ABSTRACT
Objective:To investigate the clinical effect of 90Sr application on superficial hemangioma in hair area and its effect on the volume of hair. Methods:A total of 136 pediatric patients (55 males, 81 females, 1-30 months old; 136 lesions) with head hemangioma in the First Affiliated Hospital of Guangxi Medical University between February 2018 and October 2019 were enrolled. They were divided into 3 groups according to the hair density of tumor sites. Group A ( n=63, 3(2, 6) months old, male/female=27/36): the hair in tumor sites was as thick as the surrounding hair. Group B ( n=40, 3(2, 5) months old, male/female=17/23): the hair in tumor sites was thinner than the surrounding area. Group C ( n=33, 3(2, 6) months old, male/female=11/22): there was no hair growth in the tumor sites. All groups were treated with 90Sr application, and the total absorbed dose of each course was 10-30 Gy, which was divided into 8 times. Three to four months after the treatment, the efficacy and adverse reactions were evaluated and the volume of hair was divided into 3 grades according to the hair density of the tumor sites: flourishing, good growth and no growth. If the clinical effect was unsatisfied, a second course of treatment was conducted. Kruskal-Wallis rank sum test or χ 2 test was used for data analysis. Results:The differences of age ( H=0.01), gender ( χ 2=0.92) among group A, group B and group C were not significant (both P>0.05). The total recovery rates of 3 groups after two-course treatment were 88.9%(56/63), 95.0%(38/40) and 93.9%(31/33) respectively ( χ 2=1.49, P>0.05). Besides, the incidences of adverse reactions were 6.3%(4/63), 7.5%(3/40) and 9.1%(3/33) respectively ( χ 2=0.24, P>0.05). Three to four months after treatment, the hair on tumor sites in group A and B was rated as flourishing, 28 children in group C were rated as flourishing, 5 children were rated as good growth, and none of the children showed no growth. Conclusions:The 90Sr application has a good treatment effect on the small superficial hemangioma in the hair area of infants, and the amount of hair in the affected area can be restored to normal after treatment. This treatment is worthy of clinical application.
ABSTRACT
Cutaneous hemangioma is a kind of benign skin vascular tumor caused by congenital abnormal vascular development. The rays emitted by 90Sr has a good effect on it. Meanwhile, 90Sr application is easy to operate, effective, with less side effects and painless. It is a method worthy of promotion in the treatment of skin hemangioma. This article reviews the application of 90Sr application in cutaneous hemangioma treatment.
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Objective:To investigate the correlation between 131I uptake and therapeutic efficacy in metastatic differentiated thyroid carcinoma (DTC). Methods:The clinical data of 138 patients with metastatic DTC (42 males, 96 females, age range: 8-74 years) treated with 131I in nuclear medicine departments of 31 centers all over China were retrospectively analyzed. The lesional 131I uptake was quantitatively analyzed with target-to-nontarget (T/NT) ratio through the regions of interest in metastatic lesions confirmed by either planar or tomographic 131I SPECT/CT imaging. The efficacies of 131I treatment on the metastatic DTC were divided into complete remission (CR), partial remission (PR), stable disease (SD) and progress disease (PD) based on the change of the lesion diameter before and after the treatment. Factors which may affect therapeutic efficacy were assessed by the univariate (Kruskal-Wallis rank sum test, χ2 test and one-way analysis of variance) and binary logistic regression analyses. The receiver operating characteristic (ROC) curve of lesional T/NT ratio to predict the ineffectiveness of 131I therapy was performed. Results:A total of 1 165 efficacies were evaluated. The planar imaging results ( n=653) showed that there was no statistically significant difference of T/NT ratio among CR, PR, SD and PD groups ( χ2=4.15, P>0.05). The tomographic imaging results ( n=512) suggested CR, PR, SD and PD in 7.6%(39/512), 65.8%(337/512), 22.9%(117/512), and 3.7%(19/512) of individuals, respectively, and the T/NT ratio among the four groups was significantly different ( χ2=30.46, P<0.01). The univariate analysis also showed that age, stimulated thyroglobulin(sTg), 131I dose were the factors affecting therapeutic efficacy ( F or χ2 values: 2.561, 7.095 and 8.799, all P<0.05). Furthermore, binary logistic regression analysis revealed that older patients (odds ratio ( OR)=1.034, P=0.022) or patients with lower lesional T/NT ( OR=1.086, P=0.006) had a higher probability of ineffectiveness. The area under ROC curve for T/NT ratio to predict ineffectiveness was 0.726, and the cut-off value was 6.2, with a sensitivity of 78.7%(107/136) and a specificity of 73.1%(275/376). Conclusions:131I therapy is an effective treatment for metastatic DTC. The age at the time of metastatic diagnosis and the lesional T/NT ratio are independent influential factors for ineffectiveness of 131I therapy. When the leisonal T/NT ratio is lower than 6.2, the inefficiency of 131I is higher.
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Objective To study the diagnostic value of hepatobiliary imaging at 6 h post-injection of 99 Tcm-diethyl iminodiacetic acid ( EHIDA) ( HI-6) combined with serum gamma-glutamyltransferase (γ-GT)/total bile acid ( TBA) ratio ( combined diagnosis) in children with congenital extrahepatic biliary atre-sia (CEBA). Methods Clinical data of 194 pediatric patients (118 males, 76 females, mean 70.9 d) with jaundice from May 2013 to March 2017 were retrospectively analyzed. All patients underwent surgery. According to the operation and pathologic diagnosis, patients were divided into CEBA group ( 113 cases) , infant hepatitis syndrome ( IHS) group ( 81 cases) . Serumγ-GT, TBA and the ratio ofγ-GT/TBA of the 2 groups were compared. Receiver operating characteristic ( ROC) curves were drawn to determine threshold values of the 3 parameters for diagnosis of CEBA. Patients also underwent 99 Tcm-EHIDA hepatobiliary dy-namic imaging. The diagnostic efficacies of HI-6, γ-GT, γ-GT/TBA ratio, and combined diagnosis were compared. Two-sample t test and χ2 test were used to analyze the data. Results There were significant differences in γ-GT/TBA ratio,γ-GT and TBA content between the 2 groups (t values:8.217, 9.298 and 2.426, all P<0.05). The serumγ-GT andγ-GT/TBA ratio had high diagnostic accuracies (area under ROC curve ( AUC):0.884 and 0.863) . The sensitivity, specificity, accuracy and positive predictive value of HI-6 in the diagnosis of CEBA were 91.15％(103/113), 39.51％(32/81), 69.59％(135/194) and 67.76％(103/152);the parameters of γ-GT were 69.91％(79/113), 93.83％(76/81), 79.90％(155/194) and 94.05％(79/84);and those ofγ-GT/TBA ratio were 71.68％(81/113), 92.59％(75/81), 80.41％(156/194) and 93.10％(81/87). The sensitivity of HI-6 was significantly higher than that of γ-GT and GGT/TBA ratio (χ2 values:16.256 and 14.154, both P<0.05) , but the specificity, accuracy and positive predic-tive value were significantly lower than those ofγ-GT/TBA ratio (χ2 values:50.899, 6.062 and 20.054, all P<0.05). The specificity, accuracy and positive predictive value of the combined diagnosis were 95.06％(77/81), 92.78％(180/194) and 96.26％(103/107) respectively, which were significantly higher than those of HI-6 (χ2 values:56.786, 34.168 and 31.335, all P<0.05) . Conclusions HI-6 combined withγ-GT/TBA ratio can significantly improve the diagnostic specificity and accuracy for CEBA. This method is more time-saving, simple and reliable, and has important clinical value.