氟脱氧胸苷PET-CT勾划食管癌大体肿瘤生物靶区长度的病理对照研究  

Pathological validation of FLT PET-CT in delineating the biological target length of gross tumor in esophageal carcinoma

作　　者：韩大力[1] 于甬华[1] 于金明[1] 钟小军[2] 付正[3] 穆殿斌[4] 张桂芳[1] 张百江[5] 李辉[5] 孙翔宇[4] 

机构地区：[1]山东省肿瘤医院放疗科暨山东省放射肿瘤学重点实验室,济南250117 [2]南昌大学一附院肿瘤科 [3]山东省肿瘤医院PET-CT中心,济南250117 [4]山东省肿瘤医院病理科,济南250117 [5]山东省肿瘤医院胸外科,济南250117

出　　处：《中华放射肿瘤学杂志》2010年第1期24-27,共4页Chinese Journal of Radiation Oncology

摘　　要：目的应用术后病理作为对照判断氟脱氧胸苷（FLT）PET—CT检测食管癌大体肿瘤生物靶区长度的最佳方法和最佳界值，并与FDGPET—CT、CT、食管钡餐和食管镜进行直接对照研究。方法24例患者行FLT PET—CT检查，其中22例行FDG PET—CT检查对照，全部患者均常规行食管钡餐、食管镜检查并均接受食管癌根治切除术。FLT PET-CT长度采用肉眼法，记为LFLTvisual，和采用SUV1．3、1．4、1．5以及SUVmax的20％、25％和30％分别记为LFLT1．3、LFLTL4、LFLT5、LFLT20％、LFLT25％、LFLT30％；FDG PET—CT长度采用肉眼法、SUV2．5和SUVmax的40％分别记为LFDGvisnal、LFDC2.5、LFDC40％。CT、食管钡餐和食管镜所测得病变长度分别记为LCT、LScopy和LX-ray分别与术后病理长度LPath进行比较。结果LPath值为（4．90±2．14）cm，各检测方法所得病变长度由小到大依次为LFDG40%、LScopy、LX-ray、LFLT1.5、LCT、LFLT30％、LFLTvis、LFLT1.4、LFLT125％、LFDG2.5、LFDGvis、LFLT1.3、LFLT20％，均数分别为（3．85±1．52）、（4．46±2．23）、（4．63±2．37）、（4．64±2．38）、（4．69±1．85）、（4．75±2．19）、（4．85±2．33）、（4．87±2．35）、（5．05±2．20）、（5．08±2．19）、（5．10±2．22）、（5．21±2．40）、（5．53±2．17）cm，与LPath的相关系数分别为0．91、0．93、0．88、0．95、0．90、0．81、0．96、0．96、0．80、0．99、0．99、0．95、0．79，P值均为0．000。LFLT1.4和LFDG2.5分别为最佳FLT PET—CT和FDG PET—CT长度，且LFDG3.5与LFLT1.4相似（t=1．23，P=0．232）。结论最接近食管癌病理长度的FLT PET—CT界值为SUV1．4，而FDG PET—CT的为SUV2．5，可作为客观和简便易行的半定量分析指标。Objective To establish a optimal method and threshold of 3-deoxy-3-fluorothymidine （FLT） PET-CT in delineating the biological target length of gross tumor in esophageal carcinoma, and to compare FLT PET-CT with other imaging modalities including esophagoseopy, esophagography, CT and fluorodeoxyglucose （FDG） PET-CT. Methods Twenty-four patients with esophageal squamous cell carcinoma treated with radical surgery were enrolled. Before surgery, all the patients underwent FLT PET-CT, esophagoscopy and esophagography. Twenty-two patients also received FDG PET-CT scan. Gross tumor volumes （GTV） were delineated using seven different threshold of FLT PET-CT：visual interpretation, standardized uptake value （SUV） 1.3, SUV 1.4, SUV 1.5, 20% of maximum standard uptake value （SUVmax）, 25% SUV and 30% SUVmax. Three different thresholds of FDG PET-CT were used, including visual interpretation, SUV 2.5, and 40% SUVmax. The length of tumors on FLT PET-CT scan were measured and recorded as LVLTvis, LFLT1.3 , LFLT1.4, LFLT1.5 , LFLT20% , Lflt25% , and LFLT30% , respectively. The length of tumors on FDG PET-CT scan were recorded as LVDGvis, LFDG2.5 , and LFDG40% , respectively. The length of tumors on CT, esophagography and esophagoscopy were recorded as LET, Lx-ray and LScopy. All of these results were compared with the length of gross tumor in the resected specimen measured by pathological examination （ Lpath ）.Results The LPah was （4.90 ± 2.14） cm. The Length of tumors delineated by different methods, being from short to long, were LFDG40% , LScopy, LX-tay, LFLT1.5, LCT, LFL130% , LFLTvis, LFLT1.4, LFLT25% , LFDD2.5, LFDGVvis, LFLT1.3 and LFLT20%. The mean values were （3.85 ± 1.52）, （4.46 ± 2.23）, （4.63±2.37）, （4.64 ±2.38）, （4.69 ±1.85）, （4.75 ±2.19）, （4.85 ±2.33）, （4.87±2.35）, （5.05±2.20）, （5.08 ± 2.19） , （5.10 ± 2.22 ） , （ 5.21±2.40） and （ 5.53 ± 2.17 ） cm, respeetively. The eorrelation coefficients were 0.91,0.93, 0.88, 0.95, 0.90,

关 键 词：食管肿瘤/放射疗法 体层摄影术 正电子发射型 氟脱氧胸苷 大体肿瘤体积 

分 类 号：R686[医药卫生—骨科学]