| Now neoplasm has become commonly-seen and fiequently-occurring disease that threaten people's life seveidy. It's different that the treatment of benign tumors,so it is very importantto identify the nature of the tunas before formulate the method of treatment Biopsy can identify the nature of tumors but only limited to tumors that are apt to approach and has injure to patients, nuclide imaging has been taken seriously more and more due to high sensitiveity, high specificity and no injure to patients because it uses radionuclide labeled compounds that can be uptaken by malignant tissue selectively. In solid malignant tumors , abnormal structure and function of vessel bring about decreased supply of oxygen to tumor, malignant tumor also consumes a large quantity of oxygen because it grows and metabolize quickly, so malignant tumor is often in hypoxic condition. Higher the hypoxic condition is, more malignant the tumor is. Because malignant tumor often in hypoxk; condition, specialists attach more importance on research of hypoxk agents, for example, 99Tc-mHL91, some overseas specialists have done many animal experiments about 99mTc-HL91 imaging studies suggest 99mTc-HL91 can reflect hypoxia of tumors quite good, primary clinical studies about 99mTc-HL91 imaging can identify the recurrence of tumors and the nature of turners, moreovere there aren't side effects. There isnt clinical report about 99mTc-HL91 imaging in China This study will image different tumors with 99mTc--HL91 clinically, cmpare imaging results with histopathological findings through operations or biopsy, assess the ability of 99mTc-HL91 imagingto identify the natureof tumors.Objective: The aim of the study is to evaluate the ability of 99mTc-HL91 imaging to identify the nature of tumors. Methods: Forty-eight patients(20men, 28 women) with untreated brain tumor, thyroid tumor and pulmonary tumor were studied prospectively a week before their surgical operations. They were all injeected intravenously with 740 MBq (20mCi) Tc-99m-HL91 in the arm vein. For safety measurements, vital signs were recorded and serum chemical analysis, and an ECG was performed prior to injection of 99mTc-HL91 and repeated during the investingation.Plannar images, with a matrix size of 256×256pixels, Zoom 1.0-2.0, low energy high resolution collimator were then acquired. Anterior plannar images to thyroid tumor, anterior and posterior plannar images to pulmonary tumor, anterior, posterior, leftlateral and right lateral planar images to brain tumor were acquired at 10 minutes, 2 hours and 4 hours after the intravenous injection and the tumor-to-normal ratio(T/N) were calculated. Based on the CT and 99mTc-HL91 SPECT findings surgical resection or biopsy was performed. All resected tissues were exactily localized and documented at each level to allow comparison between histopathological findings and preoperative imaging results.Results:1. After injection of 740MBq 99mTc-HL91. no adverse or subjective side effects ere noticed in any of the subjects. Their vital signs and ECG findings remained stable throughout the experiment. More over,no meaningful changes were observed in any of th clinical laboratory assays performed on repeated blood and urine specimens.2. Significant 99mTc-HL91 activity in major salivary glands, paranasal sinuses, nasal, oral and pharyngeal mucosae, liver, kidney, gastrointestine was observed, especially in liver.3. 9 patients which 99mTc-HL91 imaging are positive in 14 patients with brain tumor, 8 out of 9 patients were identified with malignant tumor, 5 patients which 99mTc-HL91 imaging are negative, 5 were all identified with benign tumor histopathologically. There is significant difference between positive rate of malignant tumor and benign tumors(P=0.003, two-sided)4. 5 patients which 99mTc-HL91 imaging are positive in 15 patients with thyroid tumor, 3 out of 5 patients were identified with malignant tumor, 10 patients which 9mTc-HL91 imaging are negative, 10were identified with benign tumor histopathological...
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