实用肿瘤学杂志 ›› 2013, Vol. 27 ›› Issue (3): 261-266.doi: 10.3969/j.issn.1002-3070.2013.03.016

• 论著 • 上一篇    下一篇

PET/CT在非小细胞肺癌放疗靶区勾画中的应用及其影响

王丽,柏晗,李文辉   

  1. 云南省肿瘤医院放射治疗中心(昆明 650118);
    昆明医科大学第三附属医院放射治疗中心
  • 收稿日期:2012-07-02 出版日期:2013-06-28 发布日期:2013-07-04
  • 通讯作者: 李文辉,E-mail:bh001925@163.com
  • 作者简介:王丽,女,(1986-),硕士,住院医师,从事肿瘤放射治疗学、肿瘤放射生物学研究

PET/CT application and it′s influence on target delineation in NSCLC radiotherapy

WANG Li,BAI Han,LI Wenhui   

  1. 1.Center of Radiation Oncology,Yunnan Tumor Hospital,Kunming 650118,China;
    2.Center of Radiation Oncology,The Third Affiliated Hospital of Kunming Medical University
  • Received:2012-07-02 Online:2013-06-28 Published:2013-07-04

摘要: 目的探讨非小细胞肺癌(Non-small cell lung cancer,NSCLC)在放射治疗中,应用PET/CT融合图像勾画靶区对靶体积及正常组织受照剂量的影响。方法 随机选择21例临床分期T3-4N0M0的NSCLC患者,分别根据CT图像和PET/CT图像勾画靶区和危及器官。分别比较基于两种影像资料所得靶区体积的大小差异,及该差异与靶区本身体积的关系;在靶区的剂量达到临床要求的条件下,比较两者的调强放射治疗(IMRT)计划中双肺Vx(即接受大于X剂量照射的肺的体积)、平均剂量(MLD)、心脏剂量和脊髓剂量的差异。结果 85.7%的病例,在CT图像上得到的靶体积(即依据传统CT资料所勾画的靶)比PET/CT大,且两者所勾画出的临床靶区(CTV)之间比较,差异具有统计学意义(P=0.001);计划靶区(PTV)之间比较差异具有统计学意义(P=0.001);两种方法所得到的靶体积差异与靶体积本身的大小呈正相关,肿瘤区(GTV)r=0.96、CTV部分r=0.82、PTV部分r=0.61;依据CT图像的计划中正常肺组织受照射剂量均较PET/CT的大,且两者肺受照20Gy以上剂量的肺体积(V20)之间比较,差异有统计学意义(P=0.017);两者肺的平均受照剂量(MLD)之间比较,差异有统计学意义(P=0.004);两者受照40Gy以上剂量的心脏体积(Vheart)之间比较,差异有统计学意义(P=0.02)。结论 应用PET/CT融合图像勾画靶区能改善靶体积和正常组织的照射剂量。

Abstract: Objective In non-small cell lung cancer(NSCLC)radiotherapy,probe target delineation and subsequent influence on target volume(TV)and exposed dose of normal tissues(NT)were based on PET/CT.Methods We selected 21 patients with NSCLC stage T3-4N0M0,and obtained TV and NT by CT images and PET/CT images,respectively.IMRT treatment plans were designed for PTVCT and PTVPET,respectively.We compared the deviation of two target volumes and exposed dose of normal tissues when target-volume-dose receives the clinical requirements.The NT′s parameters included Vx and MLD of lung,V40 of heart and maxdose of spinal cord.T-test and correlation analysis were used in the paper.Results TV of CT was greater than that of PET/CT in 85.7% cases,P=0.001(CTV),P=0.001(PTV)(statistically significant deviation).There was significant correlation between the target volume deviaton and the target volume,correlation coefficient(r)=0.96(GTV),r=0.82(CTV),r=0.61(PTV).The parameters in IMRTPET were optimizor in IMRTCT.P=0.017(V20),P=0.004(MLD)in lung and P=0.02(heartV40)in heart were statistically significant deviation.Conclusion PET/CT image has beneficial effect on target volume and normal tissues protection.

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