复发性宫颈癌调强放射治疗前^(18)F-FDG PET-CT对治疗决策的影响

Clinical impact of ^(18)F-FDG PET-CT for therapeutic decision of patients with recurrent cervical carcinoma at pre-IMRT

目的:回顾性研究氟18-氟代脱氧葡萄糖正电子发射断层(^(18)F-FDG PET)-CT对复发性宫颈癌患者调强放射治疗(IMRT)方案的影响。方法:选取36例治疗后复发的宫颈癌患者,在行IMRT前进行^(18)F-FDG PET-CT检查,并在3周之内行CT或MR等常规影像学检查,分别根据常规影像(CI)及^(18)F-FDG PET-CT勾画大体肿瘤体积(GTV)靶区,对比二者的体积差异。结果:在36例行^(18)F-FDG PET-CT检查的复发宫颈癌患者中,^(18)F-FDG PET-CT诊断复发宫颈癌患者的灵敏度、特异度及准确率分别为97.1%,100%和97.2%。^(18)F-FDG PET-CT改变了61.1%(22/36)患者的治疗方案,其中14例患者仍进行了IMRT,但放射治疗靶区因PET-CT而发生了改变。结论:^(18)F-FDG PET-CT对于复发的宫颈癌患者,是一项灵敏度、特异度及准确率较高的治疗前再分期诊断手段,改变了部分复发性宫颈癌患者的治疗方案。

Objective:The aim of this retrospective study was to evaluate the contribution of fluorine-18-fluoro-2-deoxyglucose positron emission tomography/computed tomography(18F-FDG PET-CT)for the plan of intensitymodulated radiation therapy(IMRT)on the patients with recurrent cervical carcinoma.Methods:A total of36patients with recurrent cervical carcinoma who were candidates for IMRT underwent the detection of18F-FDG PET-CT before they received IMRT.And in three weeks,they received other routine imaging detections included of CT or MR.Besides,the target area of gross tumor volume(GTV)was delineated according to conventional imaging(CI)and18F-FDG PETCT,respectively,and the difference of volume between them was compared.Results:In the36patients with recurrent cervical carcinoma who underwent the detection of18F-FDG PET-CT,the sensitivity,specificity and accuracy rate of them were97.1%,100%and97.2%,respectively.The therapeutic decision of61.1%of patients(22/36)were changed.Although other14patients still received IMRT,the target areas of radiotherapy in them also were changed due to PETCT.Conclusion:18F-FDG PET-CT is a valuable tool with higher sensitivity,specificity and accuracy rate for patients with recurrent cervical carcinoma,and it can change treatment plan in a part of them.