核医学显像在三维适形调强放疗中的应用

Applications of nuclear medicine imaging in three-dimensional conformal radiotherapy

核医学显像不仅因其能确定肿瘤范围及对肿瘤进行分期,而且因对治疗计划和病人随访的作用,目前在放射肿瘤学方面正变得愈加重要。正电子发射断层(PET)和单光子发射计算机断层(SPECT)显像在对三维适形调强放射治疗的病人确定肿瘤范围和分期中起重要作用。由于肿瘤组织的代谢改变先于形态学改变,使用功能显像技术常常能在形态学显像检出之前鉴别肿瘤组织。检测肿瘤复发18F-FDG PET有最好的灵敏度、特异性和正确率。另外,回顾了核医学显像在适形放疗的脑肿瘤、鼻咽癌、肺癌等患者中的应用。

Nuclear medicine imaging is becoming increasingly important in radiation oncology, not only for tumor staging, but also for treatment planning and follow-up. Positron emission tomography (PET) and single photon emission tomography (SPECT) imaging play a major role in the definition of tumor extent and staging of patients with cancer for three-dimensional and intensity modulated radiation therapy. Since the metabolic change of a tumor tissue usually precedes its morphological changes, it is possible to use these functional techniques to identify tumor tissue before it becomes visible in morphological images. 18F-FDG PET has the best sensitivity, specificity and accuracy in detecting tumor recurrence. In addition, the applications of nuclear medicine imaging for the patients with brain tumors, nasopharyngeal carcinoma, lung cancer, etc., in the conformal radiotherapy are also reviewed.