摘要目的 用核医学科病房服务机器人评估分化型甲状腺癌(DTC)术后患者131 I治疗后体内的放射性活度,并确定患者解除隔离时间.方法 纳入2017年9月至2018年6月间行131 I治疗的297例DTC术后患者,男94例、女203例,年龄19～80岁.根据治疗目的和131 I治疗剂量将其分为8组:4个清除残余甲状腺组织(简称清甲)组(清甲1～4组),分别采用3700 MBq(34例)、4440 MBq(122例)、5550 MBq(81例)和7400 MBq(27例)131 I清甲;4个清除DTC无法切除的转移灶(简称清灶)组(清灶1～4组),分别采用3700 MBq(1例)、4440 MBq(2例)、5550 MBq(14例)和7400 MBq(16例)131I清灶.采用核医学科病房服务机器人分别于患者服用131 I后4、24、48和72 h测定距其颈部2 cm及距其体部1 m处的剂量当量率.采用Kruskal-Wallis秩和检验与Mann-Whitney U检验比较清甲、清灶(清灶1组和2组例数少,未行比较研究)不同剂量组间剂量当量率.结果 服用131 I后4个时间点(4、24、48和72 h)清甲1～4组间的颈部剂量当量率差异均有统计学意义(H值:20.889～46.410,均P<0.05),体部剂量当量率差异也有统计学意义(H值:27.181～35.497,均P<0.05);服用131 I后24、48和72 h时清灶3组与4组间颈部剂量当量率差异有统计学意义(z值:2.328～3.076,均P<0.05),而体部剂量当量率差异无统计学意义(z值:0.333～1.621,均P>0.05).患者体内放射性活度滞留量在24 h迅速减少,随后逐渐变缓,72 h时剂量当量率低.服用131I后72 h有96.6％(255/264)的清甲患者和100％(33/33)的清灶患者周围剂量当量率低于23.3μSv/h,可解除住院隔离状态.结论 核医学科病房服务机器人可动态测量DTC术后服131 I患者体内残留放射性活度,为患者提供个体化的隔离方案.

abstractsObjective To evaluate the residual radioactivity after 131 I treatment in postoperative in-patients with differentiated thyroid carcinoma ( DTC) using service robot in nuclear medicine ward, and as-sess the time for patients to be released from isolation. Methods From September 2017 to June 2018, 297 patients ( 94 males, 203 females, age:19-80 years) with DTC who underwent 131 I treatment after surgery were included. According to the purpose of treatment and the prescription dosage of 131 I, patients were divid-ed into 8 groups:4 groups accepted 131 I remnant ablation therapy ( RAT) with different dosages, which were 3700 MBq ( RAT1, n=34) , 4440 MBq ( RAT2, n=122) , 5550 MBq ( RAT3, n=81) and 7400 MBq ( RAT4, n=27) , respectively;4 groups had 131 I treatment for recurrent/metastatic lesions ( RMLT) , and the dosages were 3700 MBq ( n=1) , 4440 MBq ( n=2) , 5550 MBq ( n=14) and 7400 MBq ( n=16) . At 4, 24, 48 and 72 h after 131 I administration, the dose equivalent rates at 2 cm away from the patient's neck and at 1 m away from the body were measured by the robot designed for nuclear medicine ward. Kruskal-Wallis rank sum test and Mann-Whitney U test were used to analyze the data. Results Neck dose equivalent rates for patients with RAT at different time points ( 4, 24, 48 and 72 h) after 131 I administration were significantly different among 4 groups (H values:20.889-46.410, all P<0.05), as well as the body&nbsp;dose equivalent rates (H values:27.181-35.497, all P<0.05). The neck dose equivalent rates at 24, 48 and 72 h after 131 I administration were statistically different between group 3 and 4 for patients with RMLT ( z values:2.328-3.076, all P<0.05;data in group 1 and 2 were too limited to be compared) , while there was no statistical difference for the body dose equivalent rates (z values:0.333-1.621, all P>0.05). The radioactivity retention in patients decreased rapidly within 24 h, then slowed down gradually and became ex-tremely low at 72 h. At 72 h after 131I administration, 96.6％(255/264) patients with RAT and 100％(33/33) patients with RMLT were lower than 23.3 μSv/h, which meant the patients could be discharged from hospitalization. Conclusions Nuclear medicine ward service robots may dynamically measure residual radi-oactivity in DTC patients who take 131 I treatment, providing individualized isolation solutions.