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山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (7): 73-77.doi: 10.6040/j.issn.1671-7554.0.2015.049

• 临床医学 • 上一篇    下一篇

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

高昂, 王世江, 付正, 孙新东, 于金明, 孟雪   

  1. 山东省肿瘤医院放射科 山东省医学科学院, 山东 济南 250012
  • 收稿日期:2015-01-13 修回日期:2015-04-16 发布日期:2015-07-10
  • 通讯作者: 孟雪。E-mail:mengxue5409@126.com E-mail:mengxue5409@126.com
  • 基金资助:
    国家自然科学基金(81472810);山东省医药卫生科技发展计划(2014WS0058);山东省科技发展计划(2014GSF118138)

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

GAO Ang, WANG Shijiang, FU Zheng, SUN Xindong, YU Jinming, MENG Xue   

  1. Department of Radiation Oncology, Shandong Cancer Hospital; Shandong Academy of Medical Sciences, Jinan 250012, Shandong, China
  • Received:2015-01-13 Revised:2015-04-16 Published:2015-07-10

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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(SUVmax),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% SUVmax勾画的感兴趣区与治疗中40% SUVmax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% SUVmax勾画的高代谢区重合率>72%。50% SUVmax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% SUVmax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% SUVmax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 (SUVmax) 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% SUVmax-delineated region of interests had large overlap fractions with the 40% SUVmax-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% SUVmax-delineated region of interests and the 80% SUVmax-delineated regions of high uptake at post-radiotherapy were more than 72%. The volume of 50% SUVmax-delineated region of interests was smaller than the gross tumor volume (GTV), with the value of being (29.4±12.3)%. However, the 50% SUVmax-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% SUVmax-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
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