【作者】 杨俊泉； 李晓阳； 刘建平； 陈宝明； 李义慧； 吴会静；

【Author】 Yang Jun-Quan Li Xiao-Yang Liu Jian-Ping Chen Bao-Ming Li Yi-Hui Wu Hui-Jing Department of Radio-chemotherapy, Tangshan People Hospital .Tangshang 063001, Hebei, China.

【机构】 唐山市人民医院放化疗科；

【摘要】 目的:探讨氟脱氧葡萄糖γ-相机型PET-CT (hPET-CT)显像与常规CT检查相对比对非小细胞肺癌 (NSCLC)合并肺不张患者行三维适形放疗(3D—CRT) 时病变靶区确定的临床意义。方法:对1 7例经组织学和 (或)细胞学检查确诊为非小细胞肺癌且CT检查合并肺不张者,先后进行胸部CT平扫和(或)强化CT和hPET- CT检查,分别勾画出大体肿瘤体积CT—GTV和hPET- CT-GTV,并分别制定出三维适形放疗(3D—CRT)的 GTV进行比较。结果:全部患者的CT-GTV与hPET-CT- GTV均有不同程度的差别,其中2例患者的hPET-CT- GTV较CT-GTV增加20％(28．5-3),CT-GTV平均为142． 5-3,hPET-CT-GTV平均为171-3;15例患者hPET／CT- GTV较CT—GTV平均减少19．3％(26-3)。CT-GTV平均为 135-3(95-190-3),hPET—CT—GTV平均为109-3(65- 155-3)(P=0．004)。GTV的减少主要原因是hPET-CT显像除外了与肿瘤组织在CT上不能区分的肺不张组织,从而导致靶区的缩小,使靶区更加精确,且避免周围正常组织不必要的照射,最大限度地保护正常组织,显示3D—CRT的优点。结论:hPET—CT显像对非小细胞肺癌(NSCLC)伴肺不张患者的肺不张组织与肺癌组织的鉴别有意义,提高了靶区定位的精确性。更多还原

【Abstract】 Objective: To investigate the potential benefit of 18F-deoxyglucose γ-camera PET-CT (FDGhPET-CT)to delineate the gross tumor volume(GTV) of non-small cell lung cancer(NSCLC) complicated with atelectasis who are to be treated with three-dimensional conformal radiation therapy(3DCRT) in comparison with the conventionality inspection. Methods: Seventeen patients histo-pathologically or cytologically proven as having NSCLC with image diagnosed as complicated with various degrees atelectasis were studied in this study. All patients were scanned with both thoracic CT and 18F-deoxyglucose γ-camera PET-CT. The GTV was delineated basing on both CT image and hPET-CT image(CT-GTV, hPET-CT-GTV) and the volume of each GTV(designated CT-GTV and hPET-CT-GTV) was compared by 3DCRT plan. Results: Each paired CT-GTV and hPET-CT-GTV was different from each other. 15 of 17 patients GTV was reduced to an average of 19.3% ( 26m3) with median CT-GTV of 135m3 (95-190m3) and median hPET-CT-GTV of 109m3 ( 65-155m3) ( P=0.004 ), 2 of 17 patients GTV increase of 20% ( 28.5-3). The reduction of hPET-CT-GTV was due to hPET-CT could so differ cancer-induced atelectasis from gross tumor that it reduced the target volume and spared more surrounding normal tissues. Show the excellency of 3DCRT. Conclusion: The incorporation of hPET-CT data with gross tumor delineation is able to improve the accuracy of 3DCRT for non-small cell lung cancer patients complicated with atelectasis.更多还原