| 石安辉,朱广迎,余荣.hPET/CT改进非小细胞肺癌调强放疗靶区勾画的研究[J].中国医学影像技术,2006,22(12):1898~1902 |
| hPET/CT改进非小细胞肺癌调强放疗靶区勾画的研究 |
| 核医学 Improvement of delineating target in intensity modulated radiation therapy for non-small cell lung cancer with 18F-FDG hPET/CT imaging |
| 投稿时间：2006-07-26 修订日期：2006-11-03 |
| DOI： |
| 中文关键词: 肺肿瘤 肺不张 调强放射治疗 脱氧葡萄糖 正电子发射断层 X-线计算机 |
| 英文关键词:Lung neoplasms Atelectasis Intensity modulated radiation therapy Deoxyglucose Positron emission tomography, X-ray computed |
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| 摘要点击次数: 3173 |
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| 中文摘要: |
| 目的 探讨18F-FDG hPET/CT对非小细胞肺癌调强放疗时靶区勾画的临床应用价值。方法 20例原发灶或锁骨上淋巴结病理组织学证实的局部晚期非小细胞患者,合并肺不张、陈旧性病灶等,先行18F-脱氧葡萄糖hPET与同机CT融合成像,然后患者带胸模行胸部CT定位扫描,层厚3~5 mm, CT定位信息经光缆传入瓦里安ECLIPSE计划系统。在ECLIPSE计划系统上,根据CT定位图像勾画出GTV1,然后参考hPET/CT融合图像在CT定位图像上勾画出GTV2,分别参考模拟定位机下肿瘤运动幅度、亚临床灶、摆位误差在ICTV1和ICTV2的基础上外扩后为PTV1和PTV2,然后利用该计划系统计算出PTV1和PTV2具体体积,并进行比较。结果 14例肺癌并肺不张和1例肺癌并陈旧性病灶患者,PTV1和PTV2的差别有高度显著性(P=0.001),PTV平均减少(212.26±200.35)cm3, 95%CI(101.31 cm3, 323.21 cm3), 最大限度保护了周围正常组织;5例CT难以判断原发灶和纵隔淋巴结性质的患者,PTV1和PTV2的差别有显著性(P＝0.037),PTV平均增加了(80.88±58.68)cm3, 95%CI (8.01 cm3, 153.04 cm3), 避免了漏照肿瘤。结论 hPET/CT融合成像在非小细胞肺癌调强放疗时,能够提高靶区勾画的准确性。 |
| 英文摘要: |
| Objective To investigate the potential value of 18F-FDG hPET/CT (hybrid positron emission tomography/computed tomography scanning) to delineate target volume in intensity modulated radiation therapy for non-small cell lung cancer. Methods Twenty non-small cell lung cancer patients diagnosed by histopathology of primary tumor or supraclavicular lymph nodes were enrolled in this study, who suffered from atelectatic lung, obsolete pulmonary nodules, and so on. All patients were scaned with both thoracic CT with slice thickness of 3-5 mm and thoracic 18F-FDG hPET/CT. According to the thoracic CT and 18F-FDG hPET/CT imaging, delineating GTV1 (gross tumor volume, GTV) and GTV2, respectively. IGTV1 (interal gross tumor volume, IGTV) and IGTV2 were delineated basing on GTV1 and GTV2 in accordance with tumor moving extent with respiratory movement. IGTV1 and IGTV2 were enlarged 8 mm (adenocarcinoma) and 6 mm (squamous carcinoma) to obtain ICTV1 (internal clinical target volume, ICTV) and ICTV2. PTV1 (planning target volume, PTV) and PTV2 were obtained basing ICTV1 and ICTV2 according to positioning error. Finally, the volume of PTV1 and PTV2 were compared by IMRT plan. Results To fourteen patients with atelectatic lung and one obsolete pulmonary tuberculosis, PTV were reduced to an average of (212.26±200.35) cm3(P=0.001), 95%CI (101.31 cm3, 323.21 cm3), which spared more surrounding normal tissues. To two patients with unknown primary lesion and three patients with unknown mediastinal lymph node, PTV were increased to an average of (80.88±58.68) cm3(P＝0.037), 95%CI (8.01 cm3, 153.04 cm3), which avoided omitting target volume. Conclusion 18F-FDG hPET/CT imaging is able to improve the accuracy of IMRT for non-small cell lung cancer patients. |
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