^(18)F-FDG PET/MR融合图像对宫颈癌大体肿瘤靶区的影响  

Effect of integrated^(18)F-FDG PET/MR on gross tumor volume of cervical cancer

作　　者：于洋[1] 李杨瞳 孙洪赞[1] YU Yang;LI Yang-tong;SUN Hong-zan(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2022年第2期139-142,共4页Journal of China Clinic Medical Imaging

基　　金：辽宁省自然科学基金项目(2019-MS-373)。

摘　　要：目的:对宫颈癌MRI大体肿瘤靶区(GTVMRI)和PET/MR融合成像大体肿瘤靶区(GTVPET/MR)进行观察者间差异分析。方法:对30例宫颈癌患者进行了^(18)F-FDG PET/MR扫描。所有原发肿瘤GTV图由4名具有5年以上临床经验的核医学医师进行讨论和处理,并测量其参数。在MRI和PET/MR融合图上分别手工逐层勾画病变范围,自动计算出GTV。计算两者GTV的交集与并集的比值,即适形度(CI)。统计学上,结果采用Pearson分析、Wilcoxon符号秩检验和单因素方差分析。结果:以GTVMRI将患者分为以下3组:<14 cm^(3)(n=9),14~<62 cm^(3)(n=16),≥62 cm^(3)(n=5)。GTVMRI与GTVPET/MR呈显著相关(r^(2)=0.96,P<0.01),观察者之间CI的相关性一般(r^(2)=0.50,P<0.01)。在<14 cm^(3)的队列中,GTVMRI,GTVPET/MR,CIMRI,CIPET/MR分别为(8.67±2.70)cm^(3)、(9.45±5.53)cm^(3)、0.63±0.06、0.57±0.09。在14~<62 cm^(3)的队列中,四者分别为(28.06±8.46)cm^(3)、(19.41±5.92)cm^(3)、0.58±0.09、0.65±0.08。在≥62 cm^(3)的队列中,四者分别为(73.45±10.94)cm^(3)、(41.47±11.28)cm^(3)、0.43±0.11、0.54±0.12。单因素方差分析组间CI值差异有统计学意义(F=9.46,P<0.01)。结论:随着肿瘤体积的增大,单独的MRI与融合PET/MR测量出的宫颈GTV差异增大。当肿瘤体积<14 cm^(3)时,MRI的一致性较好;而肿瘤在≥14 cm^(3)时,融合PET/MR产生的观察者间差异较低。此外,观察者间差异在MRI中是随着体积增大而减小的,而在融合PET/MR中是随着体积增大呈先增大后减小的趋势。Objective:To analyze the differences between the gross tumor volume of MRI(GTVMRI)and the gross tumor volume of integrated PET/MR(GTVPET/MR)in cervical cancer.Methods:Integrated PET/MR scans were conducted on 30 patients with cervical cancer.All primary tumor GTV images were discussed and processed by 4 nuclear medicine physicians with more than 5 years of clinical experience,and their parameters were measured.The lesion scope was manually delineated layer by layer on the MR image and the integrated PET/MR image respectively,and the GTV was calculated automatically.The ratio of the intersection of their GTV and the union of their GTV,namely conformality index(CI),is calculated.Statistically,the results were analyzed by Pearson analysis,Wilcoxon’s sign rank test and one-way analysis of variance.Results:Patients were divided into the following three groups based on GTVMRI:<14 cm^(3)(n=9),14~<62 cm^(3)(n=16),≥62 cm^(3)(n=5).GTVMRIwas significantly correlated with GTVPET/MR(r^(2)=0.96,P<0.01),and CI was generally correlated between observers(r^(2)=0.50,P<0.01).In the cohort with<14 cm^(3),GTVMRI,GTVPET/MR,CIMRI,and CIPET/MRwere(8.67±2.70)cm^(3),(9.45±5.53)cm^(3),0.63±0.06,and 0.57±0.09,respectively.In the 14~<62 cm^(3)cohort,they were(28.06±8.46)cm^(3),(19.41±5.92)cm^(3),0.58±0.09,and 0.65±0.08,respectively.In the cohort≥62 cm^(3),they were(73.45±10.94)cm^(3),(41.47±11.28)cm^(3),0.43±0.11,and 0.54±0.12,respectively.One-way analysis of variance showed statistically significant differences in CI between groups(F=9.46,P<0.01).Conclusion:As tumor volume increases,the difference in cervical GTV measured by MRI alone and integrated PET/MR increases.When the tumor volume is<14 cm^(3),the consistency of MRI is better.However,when the tumor is≥14 cm^(3),the differences between observers generated by integrated PET/MR is relatively low.In addition,in MRI,the differences between observers decrease with the increase of volume,while in integrated PET/MR,the differences increase first and then decrease with the

关 键 词：宫颈肿瘤 正电子发射断层显像计算机体层摄影术 磁共振成像 

分 类 号：R737.33[医药卫生—肿瘤] R817.4[医药卫生—临床医学]