^(18)F-FDGPET/CT确定局部晚期非小细胞肺癌加量放疗靶区的可行性  

A feasibility study for boost target delineation using ^(18)F-FDG PET/CT in local advanced non-small cell lung cancer

作　　者：高昂[1] 王世江[1] 付正[1] 孙新东[1] 于金明[1] 孟雪[1] 

机构地区：[1]山东省肿瘤医院放射科山东省医学科学院,山东济南250012

出　　处：《山东大学学报（医学版）》2015年第7期73-77,共5页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81472810);山东省医药卫生科技发展计划(2014WS0058);山东省科技发展计划(2014GSF118138)

摘　　要：目的评价局部晚期非小细胞肺癌患者,放疗前18F-FDG高代谢区能否识别放疗中及放疗后高代谢区,并探讨局部加量的最佳生物学亚靶区。方法在放疗前、放疗中(40 Gy)和/或放疗后,分别行18F-FDG PET/CT扫描。利用放疗前原发灶内40%~70%最大标准化摄取值(SUVmax),分别自动勾画相应的感兴趣区;计算放疗前感兴趣区与放疗中、放疗后高代谢区的空间重合率。分析放疗前感兴趣区体积与放疗敏感性指标的相关性。结果 50%SUVmax勾画的感兴趣区与治疗中40%SUVmax及手动勾画的高代谢区有较好的重合率,分别为(74.3±15.9)%和(84.4±15.3)%;与治疗后80%SUVmax勾画的高代谢区重合率>72%。50%SUVmax勾画的感兴趣区体积较原发灶肿瘤体积小,为(29.4±12.3)%。但50%SUVmax勾画的感兴趣区与放疗敏感性指标无相关性。结论放疗前18F-FDG-PET/CT扫描可以识别放疗中及放疗后的18F-FDG摄取区。50%SUVmax勾画的体积可能是适合加量的区域。Objective To evaluate whether during-radiotherapy or post-radiotherapy18F-FDG uptake locations within tumour can be identified by a pre-radiotherapy scan for non-small cell lung cancer,and to explore the optimal biological sub-volume of the primary tumor for dose escalation. Methods18F-FDG PET / CT scans were performed at pre-radiotherapy,during-radiotherapy（ 40 Gy） or post-radiotherapy. The region of interests were auto-delineated using the 40%-70% maximal standardized uptake value（ SUVmax） thresholds using pre-radiotherapy scan. Overlap fractions between pre-radiotherapy scan and during-radiotherapy or post-radiotherapy scan were calculated. Then,a Spearman correlation was used to analyze the correlations between the volumes of the region of interests and sensitivities of radiotherapy.Results The 50% SUVmax-delineated region of interests had large overlap fractions with the 40% SUVmax-delineated and manual-delineated regions of high uptake at during-radiotherapy,with the values being（ 74. 3 ± 15. 9） % and（ 84. 4 ±15. 3） %,respectively. The overlap fractions of 50% SUVmax-delineated region of interests and the 80% SUVmaxdelineated regions of high uptake at post-radiotherapy were more than 72%. The volume of 50% SUVmax-delineated region of interests was smaller than the gross tumor volume（ GTV）,with the value of being（ 29. 4 ± 12. 3） %. How ever,the 50% SUVmax-delineated region of interests had no correlations with the sensitivities of radiotherapy. Conclusion A18F-FDG PET / CT scan at pre-radiotherapy can identify the high18F-FDG uptake regions at during-radiotherapy and postradiotherapy. The 50% SUVmax-delineated volume may be a suitable region for dose boosting.

关 键 词：非小细胞肺癌 18F-FDG-PET 加量靶区勾画 剂量雕刻 

分 类 号：R734.2[医药卫生—肿瘤]