PET与PET/CT在头颈部肿瘤放射治疗中的应用

Clinical Application of PET and PET/CT in Radiotherapy of Head and Neck Cancer

正电子发射型计算机断层显像(PET)是一种功能性影像技术,而PET/CT图像融合技术则将CT解剖结构信息与PET功能代谢信息结合在一起,更为准确地显示肿瘤与周围正常组织的关系。PET与PET/CT在头颈部肿瘤放疗前分期,明确原发不明颈淋巴结转移癌原发灶,预测头颈部肿瘤放射敏感性及预后;在头颈部肿瘤放疗计划(RTP)中尤其是调强放射治疗(IMRT)中的应用;放疗后评估放疗的疗效,以及监测肿瘤复发等各个方面都受到了广泛关注。但由于其应用在很多方面存在争议,尚无大量临床证据,因此有待进一步实践和证实。

Positron emission tomography （PET） is a functional imaging modality. The combined PET and CT scan provides more accurate detection of tumors and their relationship with normal tissues by providing the functional and anatomic information simultaneously. Relevant researches have been focused on the application of combined PET/CT in the radiotherapy of head and neck cancer, which includes ： providing valuable information in the staging of head and neck cancer before radiotherapy; localizing a primary tumor in patients with unknown metastases in cervical lymph nodes; predicting the response of tumors to radiotherapy ; providing biological target volume to radiation treatment planning, especially in intensity-modulated radiotherapy; and monitoring the residual and recurrent diseases after radiotherapy. However, its application in many aspects is still controversy, and further researches in its clinical application are still needed.