胃癌PET/CT显像图像融合不良解决方案及临床意义  

The solution and clinical significance of poor fusion of PET/CT imaging images in gastric cancer

作　　者：陆皓[1] 程祝忠[1] 陈世容[1] 杨童舒 姚玉唐 LU Hao;CHENG Zhuzhong;CHEN Shirong;YANG Tongshu;YAO Yutang(PET/CT Center,Sichuan Cancer Hospital,Chengdu 610041,China)

机构地区：[1]四川省肿瘤医院PET/CT中心,四川成都610041

出　　处：《西部医学》2021年第9期1384-1387,1392,共5页Medical Journal of West China

基　　金：四川省卫健委普及应用项目(20PJ117)。

摘　　要：目的探讨可抑制胃肠道蠕动进而降低胃癌患者PET/CT检查图像病灶融合不良率的解决方案,并从定量参数的测量准确性分析其临床意义。方法纳入我院2020年1月~2020年5月间因临床怀疑胃部肿瘤行PET/CT检查的患者87例。将同层智能感兴趣区(ROI)边界勾画技术作为PET/CT图像融合质量判定方法,将融合效果分为融合良好(可以满足诊断需要)与融合不良(无法满足诊断需要)两类。患者图像行融合效果判定,其中融合不良患者23例,对融合不良的患者胃部再充盈(嘱患者床边饮用500mL水)后即行局部单床位PET/CT显像,用同样的方法再次判断图像融合效果。将23例患者首次显像的图像作为对照组,胃部再充盈后显像的图像作为观察组,对两组图像的病灶肿瘤最大标准率摄取值(SUVmax)、肿瘤代谢体积值(MTV)做统计学比较。结果首次成像,87例患者23例图像融合不良,占26.44%;23例行胃部再充盈后采集的患者中,图像融合不良的患者1例,占4.44%。观察组与对照组图像的病灶MTV40%差异无统计学意义(χ^(2)=0.00,P>0.05);SUVmax对照组明显高于观察组,差异有统计学意义(χ^(2)=8.33,P<0.05)。结论再充盈法较常规法可以明显降低胃癌患者PET/CT检查中病灶图像融合不良率,且对半定量参数SUVmax的测量起到统计学意义的改善,值得临床借鉴。Objective To explore a solution that can inhibit gastrointestinal motility and thus reduce the rate of focal fusion failure in PET/CT images of gastric cancer patients,and analyze its clinical significance from the accuracy of measurement quantitative parameters.Methods The region of interest boundary delineation technology was used as the quality determination method for PET/CT image fusion,and the fusion effect was divided into two categories:good fusion(satisfying diagnostic needs)and bad fusion(failing to meet diagnostic needs).According to the set of conditions for clinical suspicion between 2020.1-2020.5 gastric cancer need PET/CT check the images in 87 patients of decision fusion effect,including 23 patients with poor fusion,the fusion patients with bad stomach refill(tell patients bedside drink 500 mL water more)line after local single beds,PET/CT imaging in the same way again to judge image fusion effect.Moreover,images of patients undergoing initial Uptake were used as control group and images of patients undergoing gastric filling were used as observation group to statistically compare Max Standardized Uptake Value and metabolic tumor volume.Results In the first imaging,23 of 87 patients had poor image fusion,accounting for 26.44%;Among the 23 patients collected after gastric refill,1 patient had poor image fusion,accounting for 4.44%.There was no significant difference in MTV40%between the two groups(χ^(2)=0.00,P>0.05).SUVmax in the control group was significantly higher than that in the observation group,the difference was statistically significant(χ^(2)=8.33,P<0.05).Conclusion Compared with the conventional method,the refilling method can significantly reduce the defect rate of lesion image fusion in PET/CT examination of gastric cancer patients,and it is statistically significant to improve the measurement of semi-quantitative parameter SUVmax,which has clinical promotion significance.

关 键 词：胃癌 PET/CT检查 图像融合 最大标准摄取率 肿瘤代谢体积 

分 类 号：R735.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]