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术前分泌功能放射性核素成像在复发性皮质肉瘤多内脏切除中的价值:来自大批量三级肉瘤转诊中心的回顾性队列研究

Raja Haseeb Basit¹, Roshaan Malik², Hannah Tattersall³

¹Academic Department of Surgery, University of Birmingham, Birmingham, UK; Birmingham Sarcoma Service, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Major Trauma Service, Birmingham, UK.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

|December 17, 2025

概括

放射性核酸二聚糖酸 (DMSA) 扫描对逆皮质肉瘤 (RPS) 多部内脏切除 (MVR) 的手术决定的影响很小. 指导方针的变化减少了DMSA的使用,简化了患者的评估,并节省了资源.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
放射学放射学是指放射学

背景情况:

放射性核酸二聚糖酸 (DMSA) 扫描是指导方针推的,用于在多内脏切除 (MVR) 之前对功能进行手术前评估,并在逆皮质肉瘤 (RPS) 中进行封闭性瘤切除.
DMSA评估分裂功能 (SRF),以确定双侧的贡献和手术后剩余的功能.
有限的证据支持DMSA的常规使用,促使对其对外科计划的影响进行评估.

研究的目的:

评估DMSA扫描对手术规划对RPS进行MVR的患者的影响.
评估DMSA衍生的SRF与其他临床和成像数据之间的相关性.
为了确定DMSA结果是否影响了手术决定或术后功能.

主要方法:

在2010年至2023年期间,在英国一家专门的肉瘤中心,对312名被认为是RPS的MVR患者进行了回顾性队列研究.
第一阶段 (2019年之前) 代表了标准实践,而第二阶段则纳入了更有选择性的DMSA指南实施.
DMSA SRF与其他成像,并发症,检测和临床决定相关,使用≥10%的SRF差异作为显著值.

主要成果:

在165名经过手术治疗的患者中,12%的患者有不良的逆侧面SRF (≤45%).
手术前的DMSA结果对手术决策的影响很小,只有两个病例在规划中引用了不利的结果.
2019年后,DMSA的使用量显著下降,节省了成本并减少了患者的干扰,而不会对功能结果产生负面影响.

结论:

手术前的DMSA扫描显示,对RPS的MVR决策的影响很小.
基于反射性实践的准则的调整简化了在RPS中考虑MVR的患者评估途径.
该研究支持对DMSA使用采取更有选择性的方法,优化资源配置和患者管理.

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