分析FDGPET—CT与MRI影像组数在口咽鳞癌术后精确放疗的应用价值  

Clinical values of 18FDG PET-CT and MRI in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma

作　　者：黄蓉 吴慧 徐靖 卢晓旭 孙学明 王姝娟 

机构地区：[1]郑州大学附属肿瘤医院放疗科,450008

出　　处：《中华放射肿瘤学杂志》2017年第8期857-861,共5页Chinese Journal of Radiation Oncology

摘　　要：目的分析18FDGPET-CT与MRI在口咽鳞癌术后精确放疗中应用价值。方法53例口咽鳞癌患者在术后2周内行PET．CT与MRI检查，以病理活检结果作为判断标准对比二者在术后残存病灶及淋巴结转移方面的阳性检出率，并比较基于PET．CT与MRI确定的肿瘤靶区及临床靶区体积之间的差异性。结果14例患者术后残留，PET—CT诊断的敏感性、特异性、阳性预测值、阴性预测值及准确率为92．86％、94．87％、86．67％、97．37％、94．34％，MRI为57．14％、76．92％、47．06％、83．34％、71．70％，在诊断阳性淋巴结方面各值PET—CT均高于MRI（P均〈0．05），但在敏感性及阴性预测值方面相近（P均〉0．05）。14例存在术后残留患者，GTVPET．CT为（45．62±22．13）cm2，GTVMRI为（60．61±23．12）cm3（P=0．034）；CTVPET-CT为（125．54±17．53）cm3，CTVMRI为（142．18±21．22）cm2（P=0．011）。39例无术后残存患者术区及高危区照射体积CTVPET-CT为（117．87±17．66）cm3，CTVMRI为（128．05±20．65）cm3（P=0．099）。结论判断口咽鳞癌术后残存病灶及阳性淋巴结方面，PET—CT较MRI有优势，有助于放疗计划的制定。Objective To investigate the clinical values of 18F-fiuorodeoxyglucose positron emission tomography/computed tomography （18FDG PET-CT） and magnetic resonance imaging （MRI） in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma. Methods A total of 53 patients with oropharyngeal squamous cell carcinoma were enrolled and underwent PET-CT and MRI imaging within two weeks after surgery. The detection rates of residual lesions and lymph node metastases after surgery by PET-CT and MRI were compared on the basis of the pathological results of biopsy. The gross tumor volume （GTV） and clinical target volume （CTV） determined by PET-CT and MRI were compared; the normally distributed data were analyzed using the t test, and the skewed distribution data by the Wilcoxon rank sum test. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in predicting precise radiotherapy after surgery, as determined by PET-CT and MRI, were compared with the chi-square test. Results Fourteen patients had residual lesions after surgery. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET-CT in detecting residual lesions after surgery were significantly higher than those of MRI （92. 86%, 94. 87%, 86. 67%, 97.37%, and 94. 34% vs. 57. 14%, 76. 92%, 47. 06%, 83. 34%, and 71.70%, all P〈0. 05） ;the specificity, positive predictive value, and accuracy of PET-CT in detecting lymph node metastases were also significantly higher than those of MRI （all P〈0. 05）, except for the sensitivity and negative predictive value （P〉0. 05）. For the 14 patients with residual lesions, GTVrET/CT was significantly smaller than GTVMRI （45.62±22. 13 cm3 vs. 60.61±23.12 cm3, P=0.034） , so did CTV （125.54±17.53 cm3 vs. 142.18±21.22 cm3, P=0.011）. There was no significant difference between CTVpEr.CT and CTVMRI in 39 patients without residual lesions after surgery （ 117.87±17. 66 cm3 vs. 128.05±20.

关 键 词：口咽肿瘤/放射疗法 对比分析 影像组学 

分 类 号：R730.55[医药卫生—肿瘤] R739.6[医药卫生—临床医学]