^(18)F-ML-10凋亡显像PET-CT在勾画颅内肿瘤放疗靶区中的应用  

^(18)F-ML-10 as a PET tracer for apoptosis imaging in target definition of stereotactic radiotherapy for patients with intracranial tumors

作　　者：孙璐[1] 潘隆盛[1] 王伟君[1] 王金媛[1] 张治中[1] 鞠忠建[1] 李枭荣 张晓军[1] 张锦明[1] 凌至培[1] 曲宝林[1] 余新光[1] 

机构地区：[1]解放军总医院,北京100853 [2]北京锐视康科技发展有限公司,北京100071

出　　处：《解放军医学院学报》2016年第6期537-540,559,共5页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金项目(81371593)~~

摘　　要：目的探讨新型凋亡示踪剂^(18)氟标记的2-(5-氟-2-戊基)-2-甲基丙二酸(^(18)F-ML-10)PET-CT显像在立体定向放射外科治疗中对靶区勾画的指导作用。方法选取2014年1月1日-2015年12月31日解放军总医院神经外科拟行射波刀治疗的20例颅内肿瘤患者,治疗前行^(18)F-ML-10 PET-CT图像采集,由放疗物理师和高年资神经外科医师共同根据PETCT及MRI应用MIM(版本号:6.5.4)图像处理软件及射波刀治疗计划系统(Multiplan 4.0.2)进行图像融合及靶区勾画,分别得到两组相应的数据。比较两组肿瘤体积数据的差异性,应用MIM图像处理软件计算两组肿瘤位置的相似度系数(Dice系数)。结果 ^(18)F-ML-10 PET-CT能够清晰准确地显示肿瘤边界,且病变显像与正常脑组织显像对比度良好。两组资料勾画所得GTV大小差异无统计学意义(t=-1.040,P=0.311)。两组资料勾画所得GTV位置的相似度系数(Dice系数)均值为0.72;其中6例治疗后复发病例的Dice系数与其他病例差异有统计学意义(U=10.5,P=0.009),治疗后复发病例组Dice系数较低。结论 ^(18)F-ML-10 PET-CT凋亡显像有助于提高肿瘤靶区勾画的准确性,对于治疗后复发的患者建议参照PET-CT勾画靶区。Objective To investigate the performance of （18）F-labeled 2-（5-fluoropentyl）-2-methyl malonic acid（（18）F-ML-10）, a novel PET radiotracer for apoptosis, as a tool for delineating the target in the stereotactic radiotherapy（SRS） treatment plan. Methods The （18）F-ML-10 PET-CT images of 20 cases with intracranial tumors who would undergo stereotatic radiotherapy（X-Knife） were collected from January 1, 2014 to December 31, 2015 in Chinese PLA General Hospital before the start of the treatment. Gross tumor volumes（GTV） were delineated with Cyber Knife Robotic Radiosurgery System（Multiplan 4.0.2） and MIM（6.5.4） software based on PET images and MRI, respectively, by radiation engineer and senior neurosurgeon. The acquired data sets of GTV were analyzed with SPSS software（19.0） and the similarity coefficient（Dice） was calculated by MIM software. Results Tumors could be displayed clearly by PET imaging of apoptosis with （18）F-ML-10 and the contrast was high enough to distinguish the pathological field from the normal filed. There was no statistical significance in volumes of GTV between two methods（t=-1.040, P=0.311）, and the mean value of the similarity coefficient（Dice） was 0.72. The difference of similarity coefficient（Dice） between recurrence group（n=6） and initial treatment group was significant（U=10.5, P=0.009）. The recurrence group showed lower similarity coefficient（Dice）. Conclusion Integrated PET imaging of apoptosis with ^（18）F-ML-10 can improve the accuracy of target regions delineation, and it can clearly differentiate tumor from normal brain tissue.

关 键 词：颅内肿瘤 正电子发射断层扫描 肿瘤靶区 放疗计划 

分 类 号：R730.5[医药卫生—肿瘤]