PET/CT对非小细胞肺癌精确放疗计划的影响  

Impact of PET/CT on precision and accuracy of radiotherapy planning for patients with non-small cell lung cancer

作　　者：周菊英[1] 王利利[1] 蔡晓君[1] 郭建[1] 秦颂兵[1] 徐晓婷[1] 李莉[1] 俞志英[1] 

机构地区：[1]苏州大学附属第一医院放疗科,苏州215006

出　　处：《核技术》2010年第1期75-78,共4页Nuclear Techniques

摘　　要：探讨PET/CT对非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC)精确放疗(Precise and Accurate Radiotherapy,PAR)计划的影响。对21例非小细胞肺癌患者行PET/CT检查,分别根据CT和PET/CT进行TNM分期,并将PET/CT图像上的TNM分期和CT分期结果进行比较分析。利用CMS治疗计划系统图像融合软件,组织5名放疗科不同年资医师分别在CT和PET/CT三维图像上独立勾画大体肿瘤体积(Gross Tumor Volume,GTVCT和GTVPET/CT),计算患者GTV的体积值和变异系数,比较放疗科不同医师分别在CT和PET/CT上勾画GTV的差异。结果发现52.38%(11/21例)的患者TNM分期改变,21例患者GTVCT和GTVPET/CT均不相同。PET/CT可改变NSCLC临床分期,进而改变整个治疗计划。PET/CT可明显减小放疗科不同级别医师勾画GTV的差异。In order to observe impact of PET/CT on precise and accurate radiotherapy （PAR,） planning of patients with non-small cell lung cancer （NSCLC）, 21 patients with NSCLC had CT and FDG-hybrid PET examinations prospectively in radiation treatment position. Five radiation oncologists delineated independently the GTV including positive lymph nodes of 21 lung cancer patients on CT. The same observers delineated the GTV of the 21 patients on matched PET/CT scans. The size of GTV and coefficient of variation were used to assess inter-observer variability. The results show that all patients＇ GTVcT differed from their GTVP EX/CT, and the variability in the contouring of GTVCT among different physicians was statistically significant （F=9.25, P〈0.001）, but less significant in the contouring of GTVPET/CT. The mean coefficient of variation for GTV based on PET/CT was significantly smaller （t = -7.46, P〈0.001） than that for CT data only. It van be concluded that PET/CT may have notable impact on clinical staging of NSCLC and on its PAR planning, and will result in a reduction in this variation of the contouring of GTVs among different radiation oncologists.

关 键 词：非小细胞肺癌 PET/CT 精确放疗 大体肿瘤体积 

分 类 号：R817.5[医药卫生—影像医学与核医学] R814.42[医药卫生—放射医学]