PET在胶质瘤间质内放疗后疗效判定中的作用  

Value of PET in evaluating efficacy of interstitial brachytherapy for intracranial malignant gliomas

作　　者：查韡光[1] 李安民[1] 傅相平[1] 张志文[1] 欧阳巧红[2] 刘爱军[1] 易林华[1] 赵明[1] 

机构地区：[1]中国人民解放军总医院第一附属医院神经外科,北京100037 [2]中国人民解放军总医院第一附属医院核医学科,北京100037

出　　处：《中国微侵袭神经外科杂志》2006年第8期340-342,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨正电子发射断层扫描(PET)在胶质瘤间质内放射治疗后疗效观察及预后评价中的作用。方法对21例胶质瘤病人行131I间质内放射治疗,在治疗后6个月行MRI和18F-脱氧葡萄糖(18F-FDG)PET随访,并行病理活检,对比分析PET与MRI影像改变与肿瘤疗效及复发的关系。结果9例18F-FDGPET显示为局部病变区葡萄糖代谢增高,肿瘤/白质(T/WM)比值为2.79±0.20;7例显示为放射性缺损,T/WM值为0.81±0.12;5例显示病变区18F-FDG浓聚无明显改变,T/WM值为1.35±0.17。其中假阴性1例,假阳性1例。MRI难以诊断放疗后脑坏死、残存肿瘤或肿瘤复发8例。与病理活检比较,PET诊断准确率为90.5%,MRI为61.9%。结论18F-FDGPET在胶质瘤间质内放疗后区分放射性坏死与肿瘤复发方面较MRI更敏感而准确。Objective To explore the value of positron emission tomography （PET） in evaluating therapeutic efficacy and prognosis after interstitial brachytherapy for malignant gliomas. Methods Twenty-one patients with intracranial glioma were treated with ^131Ⅰ for brachytherapy. MRI and ^18F fluorodeoxyglucose positron emission tomography （^18F-FDG PET） were performed 6 months after the treatment. Pathological examinations were done to analyze the relationship between changes in PET and MRI images and both therapeutic efficacy and recurrence rate. Results ^18F-FDG PET scans showed hypermetabolism of glycose in the lesion and the tumor/white matter （T/WM） radio was 2.79±0.20 in 9 cases; 7 patients had radiation defect and T/WM ratio was 0.81±0.12. Glucose metabolism was normal and T/WM ratio was 1.35±0.17 in 5 cases. 1 case was false negative and 1 case was false positive. MRI can not diagnose brain necrosis, residual tumor and tumor recurrence in 8 cases. Compared with the pathological examinations of the 21 cases, the accuracy of distinguishing recurrent tumor was 61.9% and 90.5% for MRI and for PET respectively. Conclusion ^18SF-FDG PET is more sensitive and accurate than MRI in differentiating radionecrosis and recurrence of gliomas after interstitial brachytherapy.

关 键 词：神经胶质瘤 体层摄影术 发射型计算机 近距离放射疗法 治疗结果 

分 类 号：R739.4[医药卫生—肿瘤]