鼻咽癌治疗方案应用^(18)F-FDG PET/CT勾画方法时相效应的评估  

The evaluation of the phase effect of ^(18)F-FDG PET/CT delineation in the treatment of nasopharyngeal carcinoma

作　　者：陈杨宗[1] 唐坤[1] 林洁[1] 林信实 徐慧[1] 郑祥武[1] Chen Yangzong

机构地区：[1]温州医科大学附属第一医院,325000

出　　处：《浙江临床医学》2021年第5期649-652,共4页Zhejiang Clinical Medical Journal

基　　金：温州市科技局基金资助项目(Y2020812)。

摘　　要：目的^(18)F-FDG PET/CT成像的时相变异性会影响鼻咽癌(NPC)的代谢有效量和治疗规划,本研究旨在评估常用于NPC肿瘤体积勾画的8种方法的时相稳健性.方法选择经活检证实的NPC患者20例,并进行多次时相^(18)F-FDG PET/CT成像.确定大体肿瘤体积(GTV)、绝对SUV、基于梯度的分水岭分割(GTV-GWT)和解剖生物轮廓(GTV-ABC)值.封闭GTV-CT和8个基于PET的GTV的重叠体积,并计算重叠部分(OF-CT).颜色矩阵用于半定量时相差异比较.记录采用不同方法获得的大体肿瘤体积值,用配对t检验比较.通过用Tukey显著性检验进行方差分析,比较各组间GTV和SUVmax的时相差异.计算变异系数,以评估患者内时相变异性.计算相似系数,以评估相似性.结果使用不同勾画程序在不同时间点获得GTV差异有统计学意义.与其他方法相比,GTV-GWT(88.17%)和GTV-ABC(86.98%)获得的百分比无显著提高,表明其具有稳健性.与其他方法相比,GTV-40%(0.81~0.88)和GTV-ABC(0.82~0.88)的GTV-MRI相似性更高.结论基于PET/CT的GTV-ABC介于35~55 min,应是NPC治疗规划的首选.Objective Time-phase variability of^(18)F-FDG PET/CT imaging frequently afects metabolically active volumes and treatment planning for nasopharyngeal carcinoma(NPC).To evaluate the time-phase robustness of 8 methods commonly used for tumor volume delineation in NPC.Methods Twenty patients with biopsy-proven NPC were included and underwent multiple time-phase^(18)F-FDG PET/CT imaging.Gross tumor volumes(GTVs),absolute SUV,gradient-based watershed segmentation(GTV-GWT),and anatomic biologic contouring(GTV-ABC)values were determined.The volume of overlap between GTV-CT and the 8 PET-based GTVs was enclosed and the overlap fraction(OF-CT)calculated.Color matrix was used to semiquantify the time-phase differences.Gross tumor volume values obtained with different methods were recorded and compared using paired t test.Time-phase differences of GTVs and SUVmax were compared among groups by analysis of variance with Tukey honest significance tests.The cofficients of variation were computed to assess intrapatient time-phase variability.Similarity coefficient was calculated to evaluate similarity.Results There was a significant difference in GTV at different time points using different sketching procedures.Compared with other methods,the percentages of gtv-gwt(88.17%)and gtv-abc(86.98%)were not significantly improved,indicating that they were robust.GTV-40%(0.81~0.88)and GTV-ABC(0.82~0.88)indicated higher similarity with GTV-MRI than the other methods.Conclusions PET/CT-based GTV-ABC between 35 and 55 minutes should be the first choice for NPC treatment planning.

关 键 词：^(18)F-FDG PET PET/CT成像 GTV分割 鼻咽癌 时相变异 

分 类 号：R73[医药卫生—肿瘤]