PET/CT在肿瘤三维适形放疗中的方法学建立和应用  

The methodology and preliminary application of ^(18)F-FDG PET/CT for three-dimensional conformal radiotherapy planning in cancer patients

作　　者：管一晖[1] 左传涛[1] 赵军[1] 陈香[1] 华逢春[1] 黄喆慜 盛晓芳[2] 汪洋[2] 孙蕾[2] 薛方平[1] 林祥通[1] 

机构地区：[1]复旦大学附属华山医院核医学科PET中心,上海200235 [2]复旦大学附属华山医院放射治疗中心,上海200235

出　　处：《中华核医学杂志》2006年第6期353-356,共4页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨用PET/CT制定生物靶区行三维适形调强放疗的可行性,并判断放疗疗效。方法用Siemens Biograph Sensation 16型PET/CT仪和Varian clinical 600c和Nomos Peacock系统放疗计划系统(TPS)进行适形调强放疗技术设计研究。64例肿瘤患者,根据不同放疗部位制作放疗体模,应用激光线和自行制作的3个金属点源进行定位,将采集的PET/CT图像通过光盘存储,送至TPS进行治疗计划制定,由放疗物理师和医师根据PET和CT资料应用计划系统的图像融合软件,使图像达到融合标准后制定放疗计划靶区。治疗期间详细记录患者症状及早期放射反应,放疗结束后3个月再进行近期疗效评价。结果建立了PET/CT和Peacock适形调强放疗系统实用融合图像方法学;64例受试患者中25例(39．0%)治疗计划通过PET/CT显像发生了改变,其中20例计划靶区体积(PTV)范围增加(20/64例,31．2%),5例(5/64例,7．8%)PTV范围减小;64例患者经过PET/CT技术定位放射治疗后均取得良好疗效。结论建立在适形调强放疗系统的PET/CT融合图像方法学是完成治疗的首要问题,该方法的应用将提高制定生物靶区体积的精确性。Objective To explore the use of ^18F-fluorodeoxyglucose （FDG） imaging for delineation of the planning target volume （PTV） during three-dimensional conformal radiation therapy （3DCRT）. Methods Sixty-four tumor patients were investigated. CT and ^18F-FDG PET scanning were performed in the treatment position. The modified PTV was seen simultaneously on both CT and PET images, and the PTV information could be defined from both data. Results Method of PET/CT and 3DCRT system fusion images was established. This method could be used to delineate the target lesion and normal tissues in the 3DCRT system. In 25/64 （39.0%） patients PTV changed after PET/CT imaging, and among them, 20/64 （31.2%） increased while 5/64 （7.8%） decreased. Through the accurate delineation of PTV in PET/CT, the therapeutic effect was improved in all 64 cases after radiation. Conclusion The incorporation of PET data improves the precision of PT.V definition for the primary lesion and metastatic lymph nodes, and then elevates the therapeutic effect.

关 键 词：肿瘤 体层摄影术 发射型计算机 体层摄影术 X线计算机 放射疗法 

分 类 号：R730.5[医药卫生—肿瘤]