^(18)F-FDG摄取异质性肿瘤PET图像研究的现状

PET image analysis of tumor ^(18)F-FDG uptake heterogeneity

目的:通过分析PET图像量化肿瘤18F-FDG摄取异质性的方法,探讨肿瘤异质性在临床中的应用。方法:应用Medline及PubMed全文数据库检索系统,以"氟脱氧葡萄糖、正电子断层显像、异质性"等为关键词,检索2002-2012年相关文献,纳入标准:1)PET图像分析方法;2)定量描述肿瘤异质性;3)肿瘤异质性的临床应用,纳入符合要求的文献28篇。结果:通过不同的PET图像分析方法,可定量描述肿瘤内FDG摄取的异质性,例如累积SUV-体积直方图法(CSH),纹理分析法和数学建模法。其中,纹理分析法,在现有研究中应用最广泛。各临床研究显示,异质性新参数与患者放、化疗疗效、生存期等存在显著相关性,可用于指导个体化放疗。结论:定量描述肿瘤内18 F-FDG的摄取异质性的PET图像分析方法众多但无金标准,获得的各种肿瘤异质性新参数在描述恶性肿瘤生物学特性上有一定的临床参考价值。

OBJECTIVE：To summarize methods characterizing intra-tumor ^18F-FDG heterogeneity on PET image a- nalysis, and explore the clinical significance of tumor heterogeneity. METHODS： The full text database retrieval system of Medline and PubMed were searched from 2002 to 2012. ＂Fluorodeoxyglucose（ICDG） ,Positron Emission Computed Tomo- graphy （PET）, Heterogeneity＂ were used as key words. Totally 28 papers were selected and analyzed according to the in- clusion criteria as follows：1）Image analysis of PET;2）Quantification of heterogeneity in tumor;3）The clinical use of in- tra-tumor heterogeneity. RESULTS： Quantification of intra-tumor FDG uptake heterogeneity could be reached by different methods of PET analysis,such as cumulative SUV volume histograms （CSH）, texture features, and elliptic solid mathe- matical model with homogeneous density. Among these methods, texture features were used relatively widely. Although they are not routinely employed in clinic, studies have demonstrated that these new image parameters derived from baseline ^18 F-FDG PET images could predict response to radiochemotherapy, prognosis and guide personalized ehemo-radiotherapy. CONCLUSIONS： Intra-tumor ^18 F-FDG uptake heterogeneity could be quantified by some reliable image analysis methods. Although there is no single standard,further studies are warranted to determine the best ways to define the FDG uptake heterogeneity. It is proved that intra-tumor heterogeneity is a well-recognized feature of malignancy tumor and is useful in clinical.