宫颈癌PET-CT图像放疗靶区四种勾画方法的初步研究  

Comparison of four methods for delineation of gross tumor volume on FDG PET/CT for patients with cervical cancer

作　　者：林琳[1] 郑容[1] 吴令英[2] 吴宁[3] 张雯杰[3] 刘瑛[3] 梁颖[3] 赵平[3] 李晔雄[4] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所核医学科,北京100021 [2]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所核妇瘤科,北京100021 [3]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所PET-CT中心,北京100021 [4]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所放疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2012年第1期56-59,共4页Chinese Journal of Radiation Oncology

基　　金：卫生部临床学科重点项目（07090010）

摘　　要：目的通过比较4种勾画方法在宫颈癌FDGPET-CT图像上大体肿瘤体积（GTV）差异，寻找适合临床应用的方法。方法16例行FDGPET-CT放疗前定位的28个宫颈癌病灶的PET图像，分别用视觉勾画法（GTVvis）、SUV=2．5为边界勾画法（GTV2.5）、40％阈值边界勾画法（GTV40）、拟合公式勾画法（GTV公式）对GTV勾画，其差异比较采用成组t检验。结果GTVvisGTV2.5、GTV40、GTV公式勾画的平均体积分别为63．41、53．20、41．33、61．84cm^3，除GTV4。〈GTV。外（t=2．32，P=0．029），（GTV2.5、GTV公A与GTVvis均相似（t=1．05、0．91，P=0．305、0．370）。最大SUV值〉6或〈6、靶本底比值〉3：1或〈3：1对GTV40和GTV公＆与GTVvis差值均无影响（t=0．00、-0．34、0．92、0．35，P：1．000、0．746、0．374、0．737），但对GTV25与GTVvis差值有影响（t=-3．87、3．16，P=0．002、0．016）。结论在GTVzs、GTV公式能勾画出靶区情况下，GTV公A、GTV25和GTVvis。均相似且可用于临床，GTV㈨与GTVvis最为接近；但GTV40〈GTVvis应用时应谨慎；GTV2.5明显受病灶SUVmax值及靶本底比值影响。Objective To compare the differences in 4 sets of gross tumor volumes （GTVs） generated from FDG PET/CT in cervical cancer, and determine the optimal method for target volume delineation of cervical cancer. Methods Sixteen cervical cancer patients with 28 primary or metastatic lesions underwent FDG PET/CT. CT and PET images were coregistered, and transferred to Pinnacle therapy planning workstation. Four sets of GTVs were defined. The first set （ GTVvis ） was manually contoured using a visual method on PET images. The second set （GTV40） was autocontoured using a threshold of 40% of the maximum intensity level for PET images. The third set （ GTV2 .5 ） used an autocontour of standardized uptake value （SUV） of 2. 5 around the tumor. By phantom measurements we determined an algorithm （ threshold = （mean target concentration ＋ 2. 623 ）/1. 975 ）, GTVfunction was defined using this method as the fourth approach. The volumes of 4 sets of GTVs were compared with group t-test. Results The average volumes of GTVvis, GTV2.5 , GTV4o, and GTVfu,ction were 63.41, 53.20, 41.33, and 61.84 cm3. There was no significant difference between GTVfunction ,GTV2.5 and GTVvlS （t = 1.05,0. 91, P =0. 305,0. 37） ,but GTV4o were smaller than GTVvis. The SUVmax and target to background value had no significant influence on the differences between GTV40 and GTVfuno,ion or GTVvis （t = 0. 00, - 0. 34, 0. 92, 0. 35, P = 1. 000, 0. 746, 0. 374, 0. 737）, but they had significant influence on the difference between GTV2.5 and GTVvis （t = -3.87,3.16, P = 0. 002,0. 016）. Conclusions GTVvis, GTV2.5 and GTVfnnotion all could be used for target delineation if the method can define the GTV. The difference between the GWWfu.ctio. and GTVvis was the smallest;GTV40 was smaller than GTVvis. GTV25 was significantly influenced by SUV and target to background value of the legions.

关 键 词：氟代脱氧葡萄糖 正电子发射断层显像术 靶区勾画 宫颈肿瘤 

分 类 号：R737.33[医药卫生—肿瘤]