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PET-CT鉴别脑胶质瘤放疗后复发与坏死的研究
引用本文:刘云琴,钱立庭,汪世存,张红雁,马军,赵于飞,李广虎.PET-CT鉴别脑胶质瘤放疗后复发与坏死的研究[J].中华放射肿瘤学杂志,2011,20(3).
作者姓名:刘云琴  钱立庭  汪世存  张红雁  马军  赵于飞  李广虎
作者单位:1. 安徽医科大学附属省立医院放疗科,合肥,230001
2. 安徽医科大学附属安徽省立医院PET-CT中心
基金项目:安徽省科技攻关计划项目
摘    要:目的 应用蛋氨酸(MET)PET-GT鉴别脑胶质瘤放疗后复发与坏死.方法 30例放疗后怀疑复发或坏死的胶质瘤患者接受MET PET-CT检查,放疗结束与PET-CT检查间隔时间中位数13.5个月.复发诊断根据病理结果,坏死诊断根据病理结果 或临床随访.结果 19例MET PET-CT 检查后考虑复发患者接受手术切除或立体定向活检术,其中18例病理确诊为胶质瘤复发,1例病理确诊为坏死.11例PET-CT诊断为放疗后坏死,经长期随访(>6个月)后临床症状稳定及MRI或CT 影像诊断病灶无增大.PET-CT鉴别脑胶质瘤放疗后复发与坏死的敏感性、特异性和准确率分别为100%、91.7%和96.7%.结论 MET PET-CT可有效鉴别脑胶质瘤放疗后复发与坏死.
Abstract:
Objective To evaluate the role of 11C-methionine positron emission tomographv(MET PET-CT)in differentiating tumor recurrence from radiation necrosis in brain slioma patients.Methods From June 2008 to September 2009,30 brain glioma patients with suspected tumor recurvence or radiation necrosis after radiotherapy were evaluated by MET PET-CT.The median time between initial radiotherapy and PET examination was 13.5 months.Tumor recurrence were confirmed by histological analysis while necrosis was based on histological analysis or the subsequent clinical follow-up.Results Eighteen out of 19 patients were histologically confirmed tumor recurrence among those tumor recurrence shown by MET PET-CT after surgery or stereotactic biopsy.11 patients were considered to have radiation necrosis because of stable neurological sympotoms and without massive enlargement of the lesion during the after follow-up.The sensitivity,specificity and accuracy of MET PET-CT for detecting tumor recurrence were 100%,91.7%and 96.7%respectively.Conclusion MET PET-CT is a powerful tool in differentiating brain tumor recurrence from radiation necrosis after radiotherapy.

关 键 词:脑肿瘤/放射疗法  正电子发射体层摄影术  体层摄影术  X线计算机

The role of positron emission tomography in differentiating tumor recurrence from radiation necrosis in brain glioma patients
LIU Yun-qin,QIAN Li-ting,WANG Shi-cun,ZHANG Hong-yan,MA Jun,ZHAO Yu-fei,LI Guang-hu.The role of positron emission tomography in differentiating tumor recurrence from radiation necrosis in brain glioma patients[J].Chinese Journal of Radiation Oncology,2011,20(3).
Authors:LIU Yun-qin  QIAN Li-ting  WANG Shi-cun  ZHANG Hong-yan  MA Jun  ZHAO Yu-fei  LI Guang-hu
Abstract:Objective To evaluate the role of 11C-methionine positron emission tomographv(MET PET-CT)in differentiating tumor recurrence from radiation necrosis in brain slioma patients.Methods From June 2008 to September 2009,30 brain glioma patients with suspected tumor recurvence or radiation necrosis after radiotherapy were evaluated by MET PET-CT.The median time between initial radiotherapy and PET examination was 13.5 months.Tumor recurrence were confirmed by histological analysis while necrosis was based on histological analysis or the subsequent clinical follow-up.Results Eighteen out of 19 patients were histologically confirmed tumor recurrence among those tumor recurrence shown by MET PET-CT after surgery or stereotactic biopsy.11 patients were considered to have radiation necrosis because of stable neurological sympotoms and without massive enlargement of the lesion during the after follow-up.The sensitivity,specificity and accuracy of MET PET-CT for detecting tumor recurrence were 100%,91.7%and 96.7%respectively.Conclusion MET PET-CT is a powerful tool in differentiating brain tumor recurrence from radiation necrosis after radiotherapy.
Keywords:Brain neoplasms/radiotherapy  Positron-emission tomography  Tomography  X-ray computed
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