SD大鼠脏器重量及脏器系数正常参考值的确立与应用

目的确定本中心不同周龄SD大鼠脏器重量与脏器系数的正常参考值范围,为药物安全性评价与研究提供重要参考数据。方法以本中心近7年开展的SD大鼠长期毒性实验中空白对照组动物为数据来源,分为8～12、12～24及24～36周龄3个年龄段,每年龄段包括雌性、雄性大鼠各200只,分别统计各年龄段雌性、雄性动物的脑、心脏、肺脏、肝脏、脾脏、肾脏、肾上腺、胸腺、睾丸、附睾、卵巢与子宫等脏器重量与脏器系数,以95%可信区间作为正常参考值范围。结果与结论本中心8～12、12～24及24～36不同周龄SD大鼠脑、心脏、肺脏、肝脏、脾脏、肾脏、肾上腺、胸腺、睾丸、附睾、卵巢与子宫等脏器重量及脏器系数的正常参考值范围与其他实验室报道的结果可比性良好。     

SD大鼠脏器重量及脏器系数正常参考值的确立与应用

目的确定本中心不同周龄SD大鼠脏器重量与脏器系数的正常参考值范围,为药物安全性评价与研究提供重要参考数据。方法以本中心近7年开展的SD大鼠长期毒性实验中空白对照组动物为数据来源,分为8～12、12～24及24～36周龄3个年龄段,每年龄段包括雌性、雄性大鼠各200只,分别统计各年龄段雌性、雄性动物的脑、心脏、肺脏、肝脏、脾脏、肾脏、肾上腺、胸腺、睾丸、附睾、卵巢与子宫等脏器重量与脏器系数,以95%可信区间作为正常参考值范围。结果与结论本中心8～12、12～24及24～36不同周龄SD大鼠脑、心脏、肺脏、肝脏、脾脏、肾脏、肾上腺、胸腺、睾丸、附睾、卵巢与子宫等脏器重量及脏器系数的正常参考值范围与其他实验室报道的结果可比性良好。     

血管回声跟踪技术对男性飞行员颈动脉血管弹性的定量检测（摘要）

目的探讨血管回声跟踪技术（ET）对不同年龄组男性飞行员颈动脉血管弹性的定量检测功能。方法应用ET技术检测72例男性飞行员的颈动脉血管,根据年龄不同分为3组,并参照国人颈动脉弹性正常测量值对各年龄组与正常人的血管弹性值进行对比分析。结果左右两侧之间颈动脉弹性指标无差异;20～29岁组及30～39岁组的血管弹性与正常参考值间存在差异,     

妇女骨密度CT分析

目的测定正常妇女腰椎骨密度CT值,评价其准确性及临床意义。方法应用CIRS、BMA软件对83例各年龄组正常妇女腰椎椎体进行QCT测定。结果25-29岁妇女骨密度平均值204mg,以后随年龄增长平稳下降,至绝经期后下降增快,50～59岁平均值125.2mg。结论得出正常妇女各年龄段的椎体骨密度参考值及生理曲线,协助诊断骨质疏松症并推测骨折阈值。     

Quantitative Study of Left Ventricular Anatomic Structure and Function By 256iCT

目的 应用256iCT对正常人左心室结构和功能相关指标进行定量研究,分析各指标与年龄和性别的关系.方法 搜集506例行256iCT冠状动脉CTA结果正常的患者的影像资料;所有患者近6个月无心血管疾病病史.对原始图像进行多期重组,确定左心室舒张末期及收缩末期,分别对左心室舒张末期和收缩末期的室间隔厚度(septal wall thickness,SWT)、左室后壁厚度(posterior wall thickness,PWT)、左室宽径(LV inner diameter,LVID)、舒张末期容积( end-diastolic volume,EDV)、收缩末期容积(end-systolic volume,ESV)、每搏输出量(stroke volume,SV)和射血分数(ejection fraction,EF)进行测量和计算,并进行相关统计学处理.结果 左心室舒张末期SWT、PWT、LVID 95％参考值范围分别为:4.4～12.1 mm,4.0～14.0 mm,28.1 ～60.8 mm.左心室收缩末期SWT、PWT、LVID 95％参考值分别为:6.2～15.7mm,7.9～20.8 mm,18.1 ～46.3 mm.EDV、ESV、SV、EF 95％参考值范围分别为:55.9 ～ 165.7 ml,20.9 ～75.9 ml,25.8 ～ 98.6 ml,39.8％ ～ 78.3％.收缩期LVID和舒张期LVID值不同年龄组之间差异有统计学差异(P＜0.05),并且随着年龄增长有增大趋势.收缩期SWT、舒张期SWT、收缩期PWT、舒张期PWT以及EF值有随着年龄增长而增大的趋势,同时EDV、ESV、SV值随着年龄增长有减小的趋势,但以上各指标在不同年龄组之间的差异均无统计学意义(P＞0.05).不同性别组分析显示除EF值无统计学差异以外,其余各指标均有统计学差异(P＜0.05),且男性组各参数均大于女性组.结论 初步制定了左心室形态、功能相关参数的正常参考值,为临床诊断、危险评级及预后判断提供有意义信息.     

正常人股骨颈骨密度变化(附425例双能X线骨密度仪测量分析)

目的：了解正常人股骨近端各部位骨密度变化,以确定骨密度值的正常范围,为临床预防、诊断、治疗骨质疏松奠定基础。方法：采用双能Ｘ线骨密度仪测量４２５例正常自愿者股骨近端各部位骨密度值,男性２２２例,平均年龄４９．５７岁,女性２０３ 例,平均年龄４４．４２岁,按１０岁一个年龄组统计分析。结果：男性各部位骨峰值均分布在２０～２９岁年龄组;女性Ｌ－ Ｎｅｃｋ、Ｔｒｏｃｈ 峰值出现较晚,分布在３０～３９岁年龄组;Ｒ－ Ｎｅｃｋ、Ｗａｒｄ＇ｓ区骨峰值分布在２０～２９ 岁年龄组。男、女两性同部位之间骨密度峰值比较表明,男性股骨颈和大粗隆的值均高于女性,统计学分析有非常显著性差异（Ｐ＜ ０．０１）,同性别股骨近端双侧对照统计学结果没有显著性差异（Ｐ＞ ０．０５）。男性６０～６９岁年龄组骨密度有上升趋势。本组各部位骨峰值明显低于国内类似研究（不同机型、不同地区）的结果（Ｐ＜ ０．０１）。结论：提供了正常人各年龄组股骨近端各部位骨密度变化特点,对国人骨矿物密度正常值有重要的参考价值。为骨质疏松的研究积累了数据和资料。     

中国人身高、体重参考值

本文收集了近年米我国人口身高、体重荨体格发育调查资料,对其中科学性强代表性好的4个资料进行了统计分析(覆盖我国28个省、直辖市、自治区,从初生至60岁约92万男女城乡人口)．并与1975年的相应调查资料进行了对比,以了解我周当前人口身高、体重现状和增是的长期趋势,在此基础上考虑到国人体格发育的年龄阶段性,性别特点,城乡和地区差异,生长长期趋势和使用方便等原则．推荐了中国人男女新生儿,婴儿、幼儿、儿童,青少年和成人妁身高．体重系列参考值,并与ICRP和日本参考人身高、体重参考值进行了比较．     

电子束CT在健康国人心血管正常径线测量及功能值分析中的应用 …

目的 用电子束ＣＴ（ＥＢＣＴ）测量国人心血管正常解剖径线及心功能值，方法 ５０例健康人（男２７例，女２３例，平均年龄４７．７岁）利用ＥＢＣＴ横断和心脏短轴电影扫描，分别测量主动脉，肺动脉，左心房和左心室径线，以及左室心肌厚度，心肌增厚率等，利用心功能分析软件（ｗａｌｌ－ｓｔｕｄｙ），计算左，右室心室各功能指标，结果 得到ＥＢＣＴ心脏电影扫描各主要参数；正常国人主，肺动脉，左心室及心肌径线测量值男性     

用多变量危险函数预测冠心病的价值

我们用多变量危险函数对引起冠心病危险因素进行综合定量以预测个体发生冠心病的危险性。 40岁以上健康人53名,40岁以上冠心病158例均按1979年全国冠心病座谈会修订标准确诊。测其血清胆固醇、血压、心电图、身高、体重,计算出每人的身高体重指数。用航空医学研究所提出的多变量危险函数计算每人的危险值。其方程式为t危险值=0.18×年龄(岁)+0.08×舒张压+0.01×胆固醇+0.40×体重指数+1.22×心电图(心电图数量化方法为:正常心电图为零,大致正常心电图为1,可疑心电图为2,不正常心电图为3)。判定方法为:危险值超过下列水平时判定为阳性。即冠心病危险组:50岁以下为18.50;51～60岁为20.00,大于60岁为23.30。 按上述方程式计算出各年龄组危险值的均值以及各年龄组的阳性人数,见附表:在107例心绞痛病人组中,心电图正常或可疑正常     

电子束CT在健康国人心血管正常径线测量及功能值分析中的应用(附50例报告)

目的用电子束ＣＴ（ＥＢＣＴ）测量国人心血管正常解剖径线及心功能值。方法５０例健康人（男２７例，女２３例，平均年龄４７．７岁），利用ＥＢＣＴ横断和心脏短轴电影扫描，分别测量主动脉、肺动脉、左心房和左心室径线，以及左心室心肌厚度、心肌增厚率等；利用心功能分析软件（ｗａｌｓｔｕｄｙ），计算左、右心室各功能指标。结果得到ＥＢＣＴ心脏电影扫描各主要参数；正常国人主、肺动脉、左心房室及心肌径线测量值男性大于女性，但无显著性差异（Ｐ＞０．０５）；左、右心室收缩末容积（ＥＳＶ）、每搏输出量（ＳＶ）、射血分数（ＥＦ）、心排出量（ＣＯ）和心指数（ＣＩ），男性大于女性，但无显著性差异（Ｐ＞０．０５）；左室舒张末容积（ＥＤＶ）和肌块重量（ＭｙＭ），男性大于女性，且有非常显著性差异（Ｐ＜０．００１）。结论ＥＢＣＴ是心血管解剖和心功能值计算的准确定量方法。     

中国成年人骨骼重量参考值

为编制中国参考人提供科学依据，收集了我国南北方地区成年人４３６例的骨骼标本。经实测全身１８类骨骼的干重量；引用国外已有的骨骼湿，干重比值，首次提出了我国成年人的骨骼总重量参考值，即男性８．０ｋｇ，女性５．４ｋｇ。     

中国成年男子器官、组织和全身元素负荷量研究

目的估算60种元素在中国成年男子主要器官、组织和全身的负荷量代表值。方法依据中国4个不同膳食类型地区采集68例急死正常成年男子尸体18种器官组织样品所测60种元素浓度代表值，按中国参考人器官、组织重量参考值估算了相应器官、组织和全身负荷量。结果补充或更新了中国成年男子60种元素在18种主要器官、组织和全身负荷量代表值。结论补充或更新结果为确定中国参考人器官、组织和全身这些元素负荷量参数参考值和背景值及计算元素某些生物动力学模型参数提供了较过去更全面和有代表性的依据。     

Study of the normal internal organ weights in Tehran’s population

ObjectiveExamine the normal adult internal organ weight and its relationship with body height, body weight, body mass index and age.Materials and methodsProspective analysis of data from 1222 autopsies in Legal Medicine Organization of Iran from 1st January, 2007 to 1st September, 2008. All the subjects were adult residents of Tehran died from external causes and showed no pathological changes.ResultsThe weight of the brain, heart, lungs, liver, spleen, pancreas, kidneys, thyroid gland, the pituitary gland, the suprarenal glands, testes, prostate, ovaries and the uterus were collected from 914 males and 308 females between 15 and 88 years. The weight of all the organs was correlated statistically with at least one external parameter with the exception of the pancreas in men, the uterus, the spleen and the thyroid in women. Organ weights decreased with age except for the heart and the prostate, and increased in relation to body height and/or BMI. Except for the brain, the organ weight showed a better statistical correlation with the BMI than the body height.ConclusionThese results can be used as standard organ weights to determine abnormal evidences in Forensic and Pathologic corpses. However such results have to be regularly updated by pathologists in order to keep organ weight as a good criterion used in postmortem diagnosis.     

A stylized computational model of the rat for organ dosimetry in support of preclinical evaluations of peptide receptor radionuclide therapy with (90)Y, (111)In, or (177)Lu.

The therapeutic effects of peptide receptor-based radionuclide therapy are extensively being investigated in rats bearing tumors. Both the dose to the tumor and the therapy-limiting dose to normal tissues, such as kidneys and bone marrow, are of interest for these preclinical studies. The aim of this work was to develop a generalized computational model for internal dosimetry in rats. METHODS: Mature rats were dissected and the relative positions, dimensions, and weights of all of their major organs were measured. A mathematic model was set up for the rat body and its internal organs to enable Monte Carlo radiation transport calculations to determine estimates for both tumor and organ self-doses as cross-organ doses for (90)Y, (111)In, and (177)Lu. The organs and body were mostly of ellipsoid shape with the axes given as the measured length, width, and height normalized to values that, together with the measured weights, are consistent with the recommended soft-tissue and bone densities. A spheric tumor of 0.25 g was positioned on the right femur. Calculations were performed with the Monte Carlo neutral particle transport code MCNP for the beta-emitters (maximum energy, 2.28 MeV) and (177)Lu (maximum energy, 0.497 MeV) and for the gamma-emissions from (177)Lu and from (111)In. The presented absorbed dose S values are used to calculate the absorbed dose estimates for the rat organs in a study on the biodistribution of (177)Lu-DOTA-Tyr(3)-octreotate (DOTA is 1,4,7,10-tetraazadodecane-N,N',N",N"'-tetraacetic acid). Three activity distributions were considered in the kidney: uniform in the whole kidney, in the cortex, or in the outer 1-mm-thick rim of the cortex. Isodose curves and dose volume histograms were calculated for the dose distribution to the kidneys. RESULTS: Depending on the activity distribution in the kidneys, the renal dose for (177)Lu-DOTA-Tyr(3)-octreotate is 0.13-0.17 mGy/MBq. CONCLUSION: The renal dose of 70-95 Gy for an injected activity of 555 MBq will likely cause radiation damage, although the higher amount of peptide with this activity may influence the dosimetry by partial receptor saturation. Dose volume histograms show that (111)In and (177)Lu are likely to have a higher threshold for renal damage than (90)Y.     

52例中国人主要器官、组织中37种元素的负荷量研究

目的估算37种元素在中国成年男子主要器官、组织和全身的负荷量。方法在我国4个不同膳食类型地区补充采集21例急死正常尸体肌肉、肋骨、肝、。肾、肺、甲状腺、心、胃、脾和小肠样品，连同过去31例尸体所采集样品对37种元素的测定浓度，按中国参考人器官、组织重量参考值估算了相应器官、组织和全身的负荷量。结果获得了我国成年男子10种器官、组织中37种元素器官、组织和全身的负荷量。结论首次获得的这些结果为确定中国人器官、组织所测元素负荷量背景值和中国参考人相应负荷量参考值及生物动力学模型参数提供较前更为系统和有代表性的依据。     

Radiation exposure after <Superscript>177</Superscript>Lu-DOTATATE and <Superscript>177</Superscript>Lu-PSMA-617 therapy

Purpose

As radionuclide therapy is gaining importance in palliative treatment of patients suffering from neuroendocrine tumour (NET) as well as castration resistant prostate cancer (CRPC), the radiation protection of patients, staff, family members and the general public is of increasing interest. Here, we determine patient discharge dates according to European guidelines.

Methods

In 40 patients with NET and 25 patients with CRPC organ and tumour doses based on the MIRD concept were calculated from data obtained during the first therapy cycle. Planar whole body images were recorded at 0.5, 4, 20, 68 und 92 h postinjection. Residence times were calculated from the respective time-activity-curves based on the conjugated view method. Residence times for critical organs were fitted into the commercially available OLINDA software to calculate the organ doses. The doses of tumours and salivary glands were calculated via their self-irradiation by approximation with spheres of equivalent volume. Kidney volumes were gained by organ segmentation, volumes of all other organs were estimated by means of OLINDA and hence were lean body mass corrected. Out of the whole body curves reference points for patient discharge were estimated.

Results

In patients with NET discharge dates could be properly estimated from dosimetric data, which is not only crucial for radiation protection, but also makes therapy planning easier. For ¹⁷⁷Lu-PSMA-617 ligand therapy it is difficult to seriously estimate a generalized discharge date due to large interpatient variation resulting from different tumor loads and heavy pre-treatment.

Conclusion

Patient release is predictable for ¹⁷⁷Lu-DOTATATE therapy but not for ¹⁷⁷Lu-PSMA ligand therapy.

     

New reference tables and user-friendly Internet application for predicted heart weights

Background

Knowledge of normal heart weight ranges is important information for pathologists. Comparing the measured heart weight to reference values is one of the key elements used to determine if the heart is pathological, as heart weight increases in many cardiac pathologies. The current reference tables are old and in need of an update.

Aims

The purposes of this study are to establish new reference tables for normal heart weights in the local population and to determine the best predictive factor for normal heart weight. We also aim to provide technical support to calculate the predictive normal heart weight.

Methods

The reference values are based on retrospective analysis of adult Caucasian autopsy cases without any obvious pathology that were collected at the University Centre of Legal Medicine in Lausanne from 2007 to 2011. We selected 288 cases. The mean age was 39.2 years. There were 118 men and 170 women. Regression analyses were performed to assess the relationship of heart weight to body weight, body height, body mass index (BMI) and body surface area (BSA).

Results

The heart weight increased along with an increase in all the parameters studied. The mean heart weight was greater in men than in women at a similar body weight. BSA was determined to be the best predictor for normal heart weight. New reference tables for predicted heart weights are presented as a web application that enable the comparison of heart weights observed at autopsy with the reference values.

Conclusions

The reference tables for heart weight and other organs should be systematically updated and adapted for the local population. Web access and smartphone applications for the predicted heart weight represent important investigational tools.     

Comparison of internal radiation doses estimated by MIRD and voxel techniques for a "family" of phantoms

The aim of this study was to use a new system of realistic voxel phantoms, based on computed tomography scanning of humans, to assess its ability to specify the internal dosimetry of selected human examples in comparison with the well-established MIRD system of mathematical anthropomorphic phantoms. Differences in specific absorbed fractions between the two systems were inferred by using organ dose estimates as the end point for comparison. A "family" of voxel phantoms, comprising an 8-week-old baby, a 7-year-old child and a 38-year-old adult, was used and a close match to these was made by interpolating between organ doses estimated for pairs of the series of six MIRD phantoms. Using both systems, doses were calculated for up to 22 organs for four radiopharmaceuticals with widely differing biodistribution and emission characteristics (technetium-99m pertechnetate, administered without thyroid blocking; iodine-123 iodide; indium-111 antimyosin; oxygen-15 water). Organ dose estimates under the MIRD system were derived using the software MIRDOSE 3, which incorporates specific absorbed fraction (SAF) values for the MIRD phantom series. The voxel system uses software based on the same dose calculation formula in conjunction with SAF values determined by Monte Carlo analysis at the GSF of the three voxel phantoms. Effective doses were also compared. Substantial differences in organ weights were observed between the two systems, 18% differing by more than a factor of 2. Out of a total of 238 organ dose comparisons, 5% differed by more than a factor of 2 between the systems; these included some doses to walls of the GI tract, a significant result in relation to their high tissue weighting factors. Some of the largest differences in dose were associated with organs of lower significance in terms of radiosensitivity (e.g. thymus). In this small series, voxel organ doses tended to exceed MIRD values, on average, and a 10% difference was significant when all 238 organ doses were considered as a single group. In 12 comparisons of effective dose, the mean voxel to MIRD ratio was 1.07 (range 0.72-1.32). It was shown for the majority of cases that, whereas some large differences in SAF values exist, differences in source organ and effective dose values between the MIRD and voxel methods were largely accounted for by the respective organ mass differences. The reasons for various organ dose differences with the selected radiopharmaceuticals are discussed. Taking biological variation into account, there is reasonable agreement between the two methods but some significant differences exist that warrant further investigation. More extensive comparisons involving a wide variety of voxel phantoms are required to establish whether realistic voxel phantoms should eventually replace the MIRD system.     

Comparison of internal radiation doses estimated by MIRD and voxel techniques for a "family" of phantoms

The aim of this study was to use a new system of realistic voxel phantoms, based on computed tomography scanning of humans, to assess its ability to specify the internal dosimetry of selected human examples in comparison with the well-established MIRD system of mathematical anthropomorphic phantoms. Differences in specific absorbed fractions between the two systems were inferred by using organ dose estimates as the end point for comparison. A "family" of voxel phantoms, comprising an 8-week-old baby, a 7-year-old child and a 38-year-old adult, was used and a close match to these was made by interpolating between organ doses estimated for pairs of the series of six MIRD phantoms. Using both systems, doses were calculated for up to 22 organs for four radiopharmaceuticals with widely differing biodistribution and emission characteristics (technetium-99m pertechnetate, administered without thyroid blocking; iodine-123 iodide; indium-111 antimyosin; oxygen-15 water). Organ dose estimates under the MIRD system were derived using the software MIRDOSE 3, which incorporates specific absorbed fraction (SAF) values for the MIRD phantom series. The voxel system uses software based on the same dose calculation formula in conjunction with SAF values determined by Monte Carlo analysis at the GSF of the three voxel phantoms. Effective doses were also compared. Substantial differences in organ weights were observed between the two systems, 18% differing by more than a factor of 2. Out of a total of 238 organ dose comparisons, 5% differed by more than a factor of 2 between the systems; these included some doses to walls of the GI tract, a significant result in relation to their high tissue weighting factors. Some of the largest differences in dose were associated with organs of lower significance in terms of radiosensitivity (e.g. thymus). In this small series, voxel organ doses tended to exceed MIRD values, on average, and a 10% difference was significant when all 238 organ doses were considered as a single group. In 12 comparisons of effective dose, the mean voxel to MIRD ratio was 1.07 (range 0.72-1.32). It was shown for the majority of cases that, whereas some large differences in SAF values exist, differences in source organ and effective dose values between the MIRD and voxel methods were largely accounted for by the respective organ mass differences. The reasons for various organ dose differences with the selected radiopharmaceuticals are discussed. Taking biological variation into account, there is reasonable agreement between the two methods but some significant differences exist that warrant further investigation. More extensive comparisons involving a wide variety of voxel phantoms are required to establish whether realistic voxel phantoms should eventually replace the MIRD system.