PET/CT融合图像在非小细胞肺癌放疗靶区勾画中的临床价值  

Clinical Value of the PET/CT Fusion Image in the Radiotherapy Target Mapping of Non-Small Cell Lung Cancer

作　　者：宋志雨[1] 刘丹 马天江[1] 宋跃锋[2] SONG Zhiyu;LIU Dan;MA Tianjiang;SONG Yuefeng(Department of Oncology,Luohe Central Hospital/the First Affiliated Hospital of Luohe Medical Colleye,Luohe 462000,China;Department of Nuclear Medicine,Luohe Central Hospital/the First Affiliated Hospital of Luohe Medical Colleye,Luohe 462000,China;Department of Internal Medicine,Zhaofny District People’s Hospital Luooe City,Luohe 462000,China)

机构地区：[1]漯河市中心医院/漯河医专第一附属医院肿瘤科,河南漯河462000 [2]漯河市中心医院/漯河医专第一附属医院核医学科,河南漯河462000 [3]漯河市召陵区人民医院内科,河南漯河462000

出　　处：《河南医学研究》2022年第8期1397-1400,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(2018021028)。

摘　　要：目的探讨正电子发射断层显像/电子计算机断层扫描(PET/CT)融合图像在Ⅲ期非小细胞肺癌放疗靶区勾画中的临床价值。方法选取26例临床分期为Ⅲ期的非小细胞肺癌患者,同一固定体位下行CT和PET/CT扫描定位,根据两种图像资料分别勾画靶区和危及器官,比较肿瘤靶区(GTV)、计划靶区(PTV)体积;在靶区的剂量达到临床要求的条件下,靶区处方剂量60Gy/30f,比较两者的调强放射治疗计划中双肺V_(5)、V_(20)、肺的平均受照剂量(MLD)及心脏剂量和脊髓剂量的差异。结果所有26例患者所勾画的GTV中,20例计划的GTVCT>GTVPET/CT,3例计划的GTVCT<GTVPET/CT,GTVCT均值为(85.10±1.22)cm^(3),GTVPET/CT均值为(75.74±1.48)cm^(3),差异有统计学意义(P<0.05);GTV_(CT)均值为(190.10±10.34)cm^(3),PTV_(PET/CT)均值为(175.54±11.78)cm^(3),差异有统计学意义(P<0.05)。PTV处方剂量60Gy/30f时,PET/CT融合图像组中的双肺V_(5)、V_(20)、MLD均低于CT组,差异均有统计学意义(P<0.05)。脊髓最大剂量方面,PET/CT融合图像组均值为(3724.47±687.25)cGy,与CT组均值[(3950.29±917.62)cGy]对比,有所降低(P<0.05)。结论应用PET/CT融合图像勾画靶区显著提高靶区勾画的精确性,能很好地分辨肿瘤组织与周围的肺不张或炎症组织,改善靶区体积并降低正常肺组织的照射剂量。Objective To explore the clinical value of positron emission tomography-computed tomography(PET/CT)fusion image in the radiotherapy target mapping of stage Ⅲ non-small cell lung cancer.Methods Twenty-six patients with non-small cell lung cancer with Ⅲ clinical stage were selected,and the CT and PET/CT scanning were in the same fixed position.The target area and organ were delineated according to the two images,and the volume of tumor target area(GTV)and planning target area(PTV)were compared.Under the condition that the target dose meets the clinical requirement,the target prescription dose 60 Gy/30 f.The difference between the average dose of bilateral lung V_(5),V_(20),mean lung dose(MLD),the dose of heart and spinal cord in the intensity modulated radiotherapy plan were compared.Results Of the GTV outlined in all 26 cases,20 were planned GTV_(CT)>PTV_(PET/CT),and 3 were planned GTV_(CT)<PTV_(PET/CT)-The GTV_(CT) mean value was(85.10±122)cm^(3),GTV pet/ct mean was(75.74±148)cm^(3)(P<0.05).PTV_(CT) mean was(190.10±10.34)cm^(3),PTV pet/ct mean was(175.54±11.78)cm^(3)(P<0.05).At PTV prescription dose of 60 Gy/30 f,both lung V_(5),V_(20),and MLD in PET/CT fusion image group were lower than in CT group(P<0.05).Maximum dose of spinal cord,the mean value of PET/CT fusion image group was(3724.47±687.25)cGy,the mean value of the CT group was(3950.29±917.62)cGy,which was lower(P<0.05).Conclusion The application of PET/CT fusion image mapping can improve the accuracy of the target area mapping,can well distinguish the tumor tissue from the surrounding lung thinning or inflammatory tissue,improve the target volume and reduce the irradiation dose of normal lung tissue.

关 键 词：正电子发射断层显像/电子计算机断层扫描 非小细胞肺癌 放射治疗 靶区勾画 

分 类 号：R734[医药卫生—肿瘤]