摘要
目的:探讨11C-Choline PET/CT显像用于立体定向放射治疗的治疗计划制定的可行性,并分析其对放疗目标靶区所造成的改变。方法:34例脑肿瘤患者进行11C-Choline PET/CT的图像采集,由放疗物理师和医师根据PET和CT两组资料应用计划系统的图像融合软件分别根据单纯CT及11C-Choline PET/CT融合图像勾划肿瘤的外形轮廓并计算相应肿瘤总体积(GTV)及计划靶区体积(PTV),所得结果使用SPSS统计软件分别进行统计计算以了解应用PET/CT以后GTV及PTV增加或减少的差异情况。结果:34例患者中,有67.65%(23/34)患者的GTV有显著性改变,其中增加23.53%(8/34)(P=0.025),减少44.12%(15/34)(P=0.015)。有58.82%(20/34)患者的PTV有显著改变,其中增加20.59%(7/34)(P=0.022),减少38.24%(13/34)(P=0.007)。3例患者因发现颅内多发转移而由根治性治疗改为姑息性治疗;5例患者因未发现明显活性肿瘤组织存在依据而取消了放疗计划改为密切随访观察。结论:11C-Choline PET/CT融合图像方法学在脑肿瘤三维适形:调强放疗的应用可提高对脑肿瘤生物靶区体积制定的精确性,减少正常脑组织的照射量及遗漏病灶的可能性,使临床缓解的可能增加。实际的临床效果还有待进一步的随访及研究证实。
Objective： To investigate the possibility and the methodology of integrating ^11C-Choline PET/CT with 3D-CRT/ IMRT treatment planning of brain tumors. Methods： Thirty-four consecutive patients presenting with various intracranial tumors before radiotherapy treatment were investigated. Volume delineation was performed on the CT data and PET/CT data separately. GTV and PTV calculated based on CT and PET/CT images were compared using SPSS software. Results： The GTV increased by 25% or more because of PET in 23.53% of cases. The GTV was reduced 〉25% in 44.12% of patients. Overall, in 67.65%（23/34） of cases, GTV delineation was changed significantly if information from metabolic imaging was used in the planning process. The modification of the GTV translated into altered PTV changes in 58.52%（20/34） of cases. In 3 cases, ^11C-Choline PET/CT revealed distant metastasies, changing the treatment strategy from curative to palliative. In 5 cases, no solid evidence of tumor existence was found and their radiotherapy planning was canceled. Conclusion： Integrated ^11C-Choline PET/CT for treatment planning for 3D-CRT improves the accuracy of volume delineation compared with that of CT alone. The impact on treatment outcome remains to be demonstrated.
出处
《中国临床医学影像杂志》
CAS
北大核心
2007年第11期781-784,共4页
Journal of China Clinic Medical Imaging
