PET-CT在晚期上颌骨恶性肿瘤放射性粒子植入治疗中的应用价值研究

Preliminary investigation of PET-CT applied in malignant maxillary cancer patients undergoing radioactive seeds implantation

目的:探讨正电子发射计算机断层显像(PET-CT)引导靶区定位技术在^(125)I放射性粒子植入治疗晚期上颌骨恶性肿瘤中的应用价值。方法:选取11例上颌骨恶性肿瘤患者进行^(125)I放射性粒子植入植入前分别予以CT及PET-CT检查,将扫描数据导入近距离治疗计划系统,标记肿瘤靶区,对不同靶区设计所得的靶区体积进行比较。基于PET-CT扫描数据进行放射性粒子植入治疗。结果:PET-CT勾画的生物靶区(BTV)体积和CT勾画的大体肿瘤区(GTV)体积分别为(35.21±7.8)cm^3和(42.17±9.32)cm^3,BTV小于GTV,差异有统计学意义(t=7.25,P<0.001)。局部未见肿瘤复发,无明显并发症。结论:利用PET-CT定位的上颌骨恶性肿瘤靶区可提高放射性粒子植入治疗的精确性,具有较好的可行性与可靠性。

Objective: To investigate the value of PET-CT guided target localization technique in radioactive iodine 125 seeds implantation for treating malignant maxillary cancer. Methods: Eleven patients diagnosed with maxillary malignant tumors underwent PET-CT scans and CT scans. The three-dimensional tumor imaging generated data was converted into DICOM format by the treatment planning system. Virtual implantation was also manipulated according to the three-dimensional position of the tumor. Gross tumor volume and matched peripheral dose were compared in different imaging methods. Results: The volumes of BTV and GTV byPET-CT were (35.21±7.8) cm3 and (42.17±9.32) cm3, respectively. Compared to CT imaging, the volumes and dose were significantly smaller (t=7.25, P<0.05). No tumors recurred and there were no severe complications.Conclusions: PET-CT is a feasible and reliable method for the diagnosis and treatment of maxillary malignant tumor, and it can significantly improve the accuracy of iodine 125s eeds implantation.