肝癌影像学与病理学靶区关系的研究  

A Comparative Study on Radiology and Pathology Target Volume in Hepatocellular Carcinoma

作　　者：谢春芳[1] 刘孟忠[1] 习勉[1] 

机构地区：[1]华南肿瘤学国家重点实验室,中山大学肿瘤防治中心放射治疗科,广州市510060

出　　处：《中国肿瘤临床》2010年第21期1245-1248,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:通过比较肝癌平扫、动脉期、门脉期的影像学大体肿瘤靶区(gross tumor volume,GTV)与病理学GTV的体积,明确四者之间的关系,为准确勾画肝癌GTV提供依据。方法:收集11例在中山大学附属肿瘤防治中心行肝癌切除术的原发性肝癌患者的CT图像和术后病理标本。将患者的CT图像传送至Philips ADAC Pinnacle3 8.0计划系统,由放疗科医师分别勾画平扫、动脉期、门脉期的GTV,并计算其体积。术后病理标本按固定层厚切片,并扫描进计算机,使用Adobe Photoshop CS3 Extended软件计算各切面病理学GTV的面积,根据积分法计算病理学GTV的体积、结果:病理学GTV、平扫GTV、动脉期GTV及门脉期GTV的平均体积分别为27.67±24.84cm^3、29.43±26.83cm^3、28.13±26.34cm^3、28.57±26.81cm^3,四者之间的差异无统计学意义(P>0.05)。有包膜肿瘤组和无包膜肿瘤组GTV体积的变异系数分别为0.05±0.02、0.15±0.08,两组之间的差异无统计学意义(P=0.07)。结论:肝癌的影像学GTV与病理学GTV基本相符,影像学GTV能够代替病理学GTV。勾画肝癌靶区时应综合利用各时相CT图像所提供的信息,对于没有包膜的肿瘤,为了有效地覆盖病理学GTV,应选取最大的影像学GTV设计放疗计划。Objective： To elucidate the correlations between pathological gross tumor volume （GTV）, unenhanced CT GTV, the arterial-phase CT GTV and the portal venous-phase CT GTV of hepatocellular carcinoma （HCC）. Methods： Participants included 11 patients with histologically verified HCC who had undergone hepatectomy. Patients＇ surgical specimens and CT scans were obtained. All CT images were imported into the three-dimensional treatment planning system Philips ADAC Pinnacle 3 8.0. The radiological GTV were contoured on the unenhanced CT, arterial-phase images and portal venous-phase images and the volumes were calculated with our RT planning system. After removing the specimens, they were sliced into parallel sections. All of the pathologic slices were scanned into a computer. The pathological GTVs were contoured on Adobe Photoshop CS3 Extended software and the surfaces were calculated using the GTV delineated on the pathologic slices. The total pathological GTVs were calculated by integration. Results： The average volumes of pathological GTV, unenhanced CT GTV, arterial-phase CT GTV and portal venous-phase CT GTV were 27.67±24.84 cm^3, 29.43±26.83 cm^3, 28.13±26.34 cm^3, and 28.57±26.81 cm^3, respectively （P〉0.05）. The coefficient of variation in tumors with and without capsules was 0.05±0.02 and 0.15±0.08, respectively （P=0.07）. Conclusion： Radiological and pathological analysis of GTV yield similar results. In order to ensure all of the pathological GTVs allow for HCC without capsules, GTV on all phase CT images should be delineated and the largest GTVs chosen as the radiological GTV for planning.

关 键 词：肝肿瘤 放射疗法 靶区 影像学 病理学 

分 类 号：R735.7[医药卫生—肿瘤]