^(18)F FDG PET/CT对恶性肿瘤放射治疗方法的影响

The Impact of whole-body PET/CT on Radiotherapy of Malignant Tumor

目的:探讨18FFDGPET/CT对恶性肿瘤放射治疗的影响。方法:对148例恶性肿瘤治疗前行PET/CT扫描,对扫描前后检出病灶进行定性分析,重新确定期别和治疗方法。结果:PET/CT扫描发现恶性或可疑病灶79个,25个病灶排除或修正诊断。52例检出病灶与检查前不符,28例重新分期,12例修正诊断,57例治疗方法发生改变。结论:放射治疗前PET/CT检查,提高诊断准确性和定位的精确性,减少病灶的遗漏,对制定合理有效的治疗方案具有指导价值。

Objective: To assess the clinical performance of a integrated PET/CT system using 18F FDG in patients with malignant tumors and determines the impact of PET/CT on staging and managing patients for radiotherapy. Methods: One hundred and forty-eight consecutive cases of patients with various malignant tumors were analyzed. The Whole-body PET/CT was performed before radiotherapy and the comparison was conducted on a lesion-by-lesion basis. The lesions determined by PET/CT were compared with physical examination and conventional radiography findings. The strategy of radiotherapy before and after PET/CT scanning was compared and the change in the treatment management determined. Results: A total of 79 cases with malignant or equivocal lesions that were not previously detected in the basis of physical examination and conventional radiography were newly found by PET/CT. The diagnoses of 25 malignant lesions were modified because no lesion was found or no FDG concentration was observed on PET/CT imaging. In 28 patients (18.9%) the stage were changed due to PET/CT results. In 57 patients (38.5%) management in radiotherapy were changed due to PET/CT results. In 18 patients (12.2%) radiotherapy was not performed after PET/CT. In 10 patients (6.8%) the intention of radiation treatment (curative/palliative) were changed due to PET/CT results. Correction of radiation dose was made in 17patients (11.5%). Correction of the target volume was made in 28 patients (18.9%). Conclusion: The Whole-body PET/CT performed before radiotherapy increases the accuracy of the diagnosis and the definition of the orientation, and decreases the focus omitted. It is valuable to direct the treatment planning of radiotherapy.