18F-FDG PET/CT确定局部晚期非小细胞肺癌加量放疗靶区的可行性

doi:10.6040/j.issn.1671-7554.0.2015.049

摘要/Abstract

摘要： 目的评价局部晚期非小细胞肺癌患者, 放疗前¹⁸F-FDG高代谢区能否识别放疗中及放疗后高代谢区, 并探讨局部加量的最佳生物学亚靶区。方法在放疗前、放疗中(40 Gy)和/或放疗后, 分别行¹⁸F-FDG PET/CT扫描。利用放疗前原发灶内40%~70%最大标准化摄取值(SUV_max),分别自动勾画相应的感兴趣区;计算放疗前感兴趣区与放疗中、放疗后高代谢区的空间重合率。分析放疗前感兴趣区体积与放疗敏感性指标的相关性。结果 50% SUV_max勾画的感兴趣区与治疗中40% SUV_max及手动勾画的高代谢区有较好的重合率, 分别为(74.3±15.9)%和(84.4±15.3)%;与治疗后80% SUV_max勾画的高代谢区重合率>72%。50% SUV_max勾画的感兴趣区体积较原发灶肿瘤体积小, 为(29.4±12.3)%。但50% SUV_max勾画的感兴趣区与放疗敏感性指标无相关性。结论放疗前¹⁸F-FDG-PET/CT扫描可以识别放疗中及放疗后的¹⁸F-FDG摄取区。50% SUV_max勾画的体积可能是适合加量的区域。

关键词: 剂量雕刻, 非小细胞肺癌, ¹⁸F-FDG-PET, 加量靶区勾画

Abstract: Objective To evaluate whether during-radiotherapy or post-radiotherapy ¹⁸F-FDG uptake locations within tumour can be identified by a pre-radiotherapy scan for non-small cell lung cancer, and to explore the optimal biological sub-volume of the primary tumor for dose escalation. Methods ¹⁸F-FDG PET/CT scans were performed at pre-radiotherapy, during-radiotherapy (40 Gy) or post-radiotherapy. The region of interests were auto-delineated using the 40%-70% maximal standardized uptake value (SUV_max) thresholds using pre-radiotherapy scan. Overlap fractions between pre-radiotherapy scan and during-radiotherapy or post-radiotherapy scan were calculated. Then, a Spearman correlation was used to analyze the correlations between the volumes of the region of interests and sensitivities of radiotherapy. Results The 50% SUV_max-delineated region of interests had large overlap fractions with the 40% SUV_max-delineated and manual-delineated regions of high uptake at during-radiotherapy, with the values being (74.3±15.9)% and (84.4±15.3)%, respectively. The overlap fractions of 50% SUV_max-delineated region of interests and the 80% SUV_max-delineated regions of high uptake at post-radiotherapy were more than 72%. The volume of 50% SUV_max-delineated region of interests was smaller than the gross tumor volume (GTV), with the value of being (29.4±12.3)%. However, the 50% SUV_max-delineated region of interests had no correlations with the sensitivities of radiotherapy. Conclusion A ¹⁸F-FDG PET/CT scan at pre-radiotherapy can identify the high ¹⁸F-FDG uptake regions at during-radiotherapy and post-radiotherapy. The 50% SUV_max-delineated volume may be a suitable region for dose boosting.

Key words: Dose painting, Non-small cell lung cancer, ¹⁸F-FDG-PET, Boost target delineation

中图分类号:

R734.2

高昂, 王世江, 付正, 孙新东, 于金明, 孟雪. ¹⁸F-FDG PET/CT确定局部晚期非小细胞肺癌加量放疗靶区的可行性[J]. 山东大学学报（医学版）, 2015, 53(7): 73-77.

GAO Ang, WANG Shijiang, FU Zheng, SUN Xindong, YU Jinming, MENG Xue. A feasibility study for boost target delineation using ¹⁸F-FDG PET/CT in local advanced non-small cell lung cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(7): 73-77.

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¹⁸F-FDG PET/CT确定局部晚期非小细胞肺癌加量放疗靶区的可行性

A feasibility study for boost target delineation using ¹⁸F-FDG PET/CT in local advanced non-small cell lung cancer

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