FDG PET—CT标准摄取值在预测放射性肺炎发生中的作用  

Application of standardized uptake value for FDG PET-CT in predicting radiation pneumonitis

作　　者：张永[1] 于甬华[1] 于金明[1] 何为[1] 付正[2] 郭守芳[2] 刘希军[1] 丛昌盛[1] 

机构地区：[1]山东省肿瘤医院放射治疗科,济南250117 [2]山东省肿瘤医院PET-CT中心,济南250117

出　　处：《中华肿瘤杂志》2009年第8期622-625,共4页Chinese Journal of Oncology

基　　金：山东省科技厅攻关项目（2007GG20002042）

摘　　要：目的探讨肺癌患者放射治疗前后FDGPET-CT标准摄取值（SUV）及其变化在预测放射性肺炎发生中的作用。方法40例未经手术的非小细胞肺癌（NSCLC）患者在放射治疗前后均行PET-CT检查，分别测量出受照≤5Gy、5．1～15Gy、15．1～35Gy、35．1—60Gy以及〉60Gy肺组织放射治疗前后的平均SUV，比较发生放射性肺炎组与未发生放射性肺炎组SUV的变化情况，以及受照肺组织的SUV与未受照射肺组织SUV值之比（L／B）。结果40例患者中，有8例在治疗后发生放射性肺炎，其中2级6例，3级2例。受照剂量35．1—60Gy肺组织的SUV与放射性肺炎的发生明显相关，当SUV≥1时，放射性肺炎的发生率为41．7％，明显高于全组放射性肺炎的发生率（20．0％；χ^2=3．96，P〈0．05），SUV预测放射性肺炎的敏感度和特异度分别为62．5％和78．1％。L／B≥2．5时，放射性肺炎的发生率为40．7％，亦明显高于全组放射性肺炎的发生率（20．0％；χ^2=4．92，P〈0．05）。以L／BI〉2．5为标准预测放射性肺炎的敏感度和特异度分别为72．7％和90．9％。SUV≥1与L／B≥2．5在预测放射性肺炎发生率之间的差异无统计学意义（r=0．002，P〉0．05）。结论SUV和L／B的大小与放射性肺炎的发生呈正相关，临床医生可根据FDGPET—CT提供的SUV和L／B来预测放射性肺炎的发生。Objective To investigate the correlation of radiation pneumonitis （RP） with standardized uptake value （SUV） for fluorodeoxyglucose （FDG） positron emission tomography and computed tomography （PET-CT） in lung cancer patients treated with radiation therapy. Methods Fourty patients with unresectable non-small cell lung cancer （ NSCLC ） received FDG PET-CT before and after radiotherapy. The average SUV of the lung tissue irradiated with a dose of ≤5 Gy, 5.1 - 15 Gy, 15.1 - 35 Gy, 35.1 - 60 Gy, 〉 60 Gy were measured. The correlation between SUV and RP was analyzed by comparing the SUV in the patients with RP and without. The SUV ratio of the irradiated lung tissue to that of the non-irradiated lung tissue （L/B） was also calculated. Results Of the 40 patients, 8 developed RP, including 6 cases of grade 2 and 2 cases of grade 3. The SUV of irradiated lung tissues with a dose of 35. 1 - 60 Gy was significantly correlated with RP. When SUV ≥ 1, the RP incidence rate was 41.7% versus 20.0% in the whole group, with a statistically significant difference. （χ2 = 3. 96, P 〈 0. 05 ）. The sensitivity and specificity of SUV in predicting RP was 62.5% and 78.1%, respectively. When the value of L/B≥2.5, the RP incidence rate was 40.7% in this group versus 20. 0% in the whole group, with a statistical significance （χ2 = 4.92,P 〈 0.05）. If taking L/B≥2.5 as a threshold value, the sensitivity and specificity in predicting RP was 72.7% and 90.9%, respectively. No statistically significant difference was found in predicting radiation pneumonitis between SUV≥1 and L/B≥2.50（2 = 0.002, P〉0.05）. Conclusion The standardized uptake value （SUV） and the SUV ratio of the irradiated lung tissue to that of the non-irradiated lung tissue （L/B） for FDG PET-CT are positively correlated with radiation pneumonitis, and clinicians may use it to predict the occurrence of radiation pneumonitis.

关 键 词：非小细胞肺癌 体层摄影术 正电子发射型 标准摄取值 放射性肺炎 

分 类 号：R686[医药卫生—骨科学]