鼻咽癌不同模式放疗后的PET/CT早期评估价值的研究  

Early evaluation value of PET/CT in nasopharyngeal carcinoma after different models of radiotherapy

作　　者：冯彦林[1] 王颖[1] 张宁[2] 冼伟均[1] 温广华[1] 张洋[2] 陈露斯[2] 

机构地区：[1]佛山市第一人民医院核医学科,528000 [2]佛山市第一人民医院放疗科,528000

出　　处：《国际放射医学核医学杂志》2014年第4期223-226,246,共5页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：佛山市医学科技攻关项目（20111021010125）

摘　　要：目的 研究鼻咽癌在适形放疗（CRT）和调强放疗（IMRT）不同模式放疗后1周18F-FDG PET/CT显像早期评估的价值.方法 对CRT组21例及IMRT组19例患者放疗后1周进行PET/CT显像评估,分别进行目测分析及测量最大标准化摄取值（SUVmax）,并与两年临床随访结果及病理活检结果进行对照.结果 CRT组患者2年临床随访无肿瘤残留,IMRT组17例患者活检结果无残留、2例活检结果为阳性;放疗前PET/CT显像CRT组与IMRT组的SUVmax分别为9.57±4.33、9.40±3.32,两组间差异无统计学意义（t=-0.43,P=0.132）;放疗后CRT组与IMRT活检阴性组的SUVmax分别为2.38±0.34、3.10±0.55,两组间差异有统计学意义（t=-3.4,P=0.002）.CRT组目测诊断准确率为76.2％,目测假阳性率为23.8％;IMRT组目测诊断准确率为63.2％,目测假阳性率为36.8％.结论 放疗后1周作为18F-FDG PET/CT对鼻咽癌CRT后评估时间点是可行的;放疗后1周IMRT组的SUVmax较高,不是PET/CT的最佳评估时间点.Objective To study the early evaluation value of 18F-FDG PET/CT imaging in nasopharyngeal carcinoma on the 7-day after different models of radiotherapy,including conformal radiotherapy（CRT） and intensity-modulated radiotherapy（IMRT）.Methods PET/CT imaging was performed in 21 cases of CRT group and 19 cases of IMRT group on the 7-day after radiotherapy.The visual examination was performed and the maximum standardized uptake value （SUVmax） was measured,and the results were compared with the two years clinical follow-up and the result of pathological biopsy.Results Two years clinical follow-up of the CRT group confirmed there was no residual tumor.There was no residual tumor in 17 cases and 2 cases were positive of the IMRT group confirmed by biopsy.The SUVmax of the CRT group and the IMRT group were 9.57±4.33 and 9.40±3.32 respectively before radiotherapy without significant difference（t=-0.43,P=0.132）.SUVmax of the CRT group and the negative patients confirmed by biopsy of the IMRT group were 2.38±0.34 and 3.1 ±0.55 respectively after radiotherapy with significant difference （t=-3.4,P=0.002）.The accuracy rate and the false positive rate of visual examination of the CRT group were 76.2% and 23.8% respectively.The accuracy rate and the false positive rate of visual examination of the IMRT group were 63.2% and 36.8% respectively.Conclusions One week after nasopharyngeal carcinoma CRT is the feasible time-point for 18F-FDG PET/CT assessment.SUVmax of the IMRT group on 7-day after radiotherapy was higher than that in CRT group,so this time-point is not the best evaluation timepoint of the PET/CT.

关 键 词：鼻咽肿瘤 正电子发射断层显像术 放射疗法 适形 放射疗法 调强适形 

分 类 号：R739.63[医药卫生—肿瘤]