FDGPET—CT与MRI在鼻咽癌原发灶靶区勾画中的对比研究  

Comparative study of gross tumor volume shown on MRI and FDG PET/CT of nasopharyngeal carcinoma

作　　者：林勤[1] 吴华[2] 朱鹭超[1] 傅丽蓉[1] 戴明明[1] 王丽琛[1] 

机构地区：[1]厦门大学附属第一医院放疗科,361003 [2]厦门大学附属第一医院核医学科及闽南PET中心,361003

出　　处：《中华放射肿瘤学杂志》2012年第6期492-495,共4页Chinese Journal of Radiation Oncology

基　　金：福建省科技项目计划重点项目（闽科技计[2008]59号-11）;福建省卫生厅青年基金（2008-1-51）;厦门市科技计划指导性项目（3502220077056）;厦门市科技局指导性项目（3502220077053）

摘　　要：目的对比研究FDGPET—CT不同勾画方法间及与MRI显示鼻咽原发灶靶区差异，探讨FDGPET—CT勾画鼻咽原发灶大体肿瘤体积（GTV）生物靶区的可行性。方法50例初治鼻咽癌患者治疗前均行FDGPET—CT和MRI检查，先在MRI图像上勾画GTV得到GTV—MRI，然后在FDGPET—CT上分别用目测法或不同阈值法（30％、40％、50％SUVmax）勾画GTV得到GTV—PETvis、GTV—PET30、GTV—PET40、GTV—PET50。采用Wilcoxon检验GTV—PET不同方法间和GTV—MRI差异，以及不同T分期中不同勾画方法间差异。结果全组GTV—MRI、GTV—PETvis、GTV—PET30、GTV—PET40、GTV—PET50分别为27．8、22．2、22．7、14．4、9．0cm3，除GTV-PETvis与GTV—PET30间（Z==0．05，P=0．958）以及T1～2期（25例）GTV—MRI与GTV-PETvis和GTV—PET30相似外（Z=-0．93、-0．93，P=0．353、0．353），其余均不同（Z=-5．74～-2．09，P=0．000～0．037）。结论应用FDGPET—CT不同方法勾画的GTV—PET均〈GTV—MRI。FDGPET—CT目测法或以30％SUVmax为阈值自动勾画鼻咽原发灶GTV可实现生物代谢肿瘤体积范围勾画。Objective To compare gross tumor volume （GTV） of nasopharyngeal carcinoma （NPC） according to MRI and FDG PET/CT and to investigated four fixed threshold methods to delineate the GTV using FDG PET/CT. Methods Fifty patients with primary biopsy-proven NPC were prospectively were enrolled into the study. FDG PET/CT scans and MRI were carried out within one week prior to pretreatment, respectively. The GTV was named GTV-MRI （ GTV were delineated according to MRI） , GTV-PETviS, GTV- PET30, GTV-PET4o, GTV-PETso （ GTV was delineated according to the PET-based GTVs obtained by visual interpretationor, by percentage of the SUVm= （30%, 40%, 50%） thresholds, respectively）. The differences were compared among the GTV-MRI, GTV-PETvis, GTV-PET30, GTV-PET40 and GTV-PET50 in different by Wilcoxon test. Results Of 50 patients, the median of volume descending order were ： GTV-MRI 27.8 cm3 , GTV-PETvis 22. 2 cm3 , GTV-PET30 22. 7 cm3 , GTV-PET40 14.4 cm3 and GTV-PET50 9.0 cm3. However, there was no significant difference between GTV-PETvis and GTV-PET30 （Z= -0.05, P= 0. 958）,as well as GTV-MRI and GTV-PETvis or GTV-PET30 in 25 patients who were T1-2 stage （Z= - 0. 93, - 0. 93, P = 0. 353,0. 353 ） , the other GTVs were all different in 50 patients＇ （ Z = - 5.74- - 2. 09, P = 0. 000 - 0. 037 ）. Conclusions All the GTVs delineated by the different methods of using FDG PET/CT were less than the GTV delineated by MRI. The potential advantages with the GTV-PETvis or GTV-PET3o delineated by FDG PET/CT are reduction of biological metabolic tumor volume in GTV delineation and reduction of the size of the GTV in NPC patients.

关 键 词：磁共振成像 体层摄影术 正电子发射 x线计算机 鼻咽肿瘤 大体肿瘤体积勾画 

分 类 号：R730.44[医药卫生—肿瘤]