FDG PET/CT在胸部肿瘤放疗中的应用

目的总结葡萄糖类似物（FDG）PET/CT在胸部肿瘤放疗中应用的初步经验。方法 2009年8月~2011年12月,42例胸部肿瘤患者在我院接受PET/CT（GE Discovery）定位。图像传至VarianEclipse 8.6治疗计划系统进行图像分析处理及治疗计划设计。分析PET/CT图像融合对认定肿瘤靶区范围及对总体放疗方案和治疗计划的影响。结果 42例患者共确诊肿瘤病灶109个,其中,80.7%病灶在CT和PET图像均明确显示;19.3%病灶通过融合PET图像而确诊。融合图像在明确小的转移性淋巴结方面有显著优势。在肺部病灶大小和范围的显示上PET图像与CT图像常有一定差异,可能与呼吸运动或/和化疗影响肿瘤糖代谢有关。通常FDG PET/CT不能有效鉴别肿瘤与合并的炎症和手术创伤。结论 FDG PET/CT应用显著提高了肿瘤的诊断水准,并对放疗方案和治疗计划产生积极影响,但仍需探求排除假阳性信息的有效方法。

Application of FDG PET/CT in Radiotherapy of Thorax Tumors

Objective To summarize the application of Fluorodeoxyglucose positron emission tomography/computed tomography（FDG PET/CT） in radiotherapy of thorax tumors.Methods Between Aug.2009 and Dec.2011,42 patients underwent FDG PET/CT scanning（Discovery,GE.Co.） in our hospital.Images were transferred to the treatment planning system（TPS,Eclipse 8.6,Varian Co.） through local network.This paper researches the changes happened on tumor confine and radiotherapy plans and general treatment strategy.Results 109 malignant lesions were diagnosed in 42 patients.80.7% of the lesions were shown clearly on CT and PET respectively,and 19.3% of the lesions were detected by PET.Fusion images（PET/CT） had an obvious advantage than alone CT on detecting small malignant lymph nodes.Tumor shape and area on PET were often different with that on CT,which perhaps is related to breath movement or/and chemical treatment restraining glucose metabolism.In general,FDG PET/CT couldn＇t effectively distinguish tumors from inflammation or operation injury.Conclusion Application of FDG PET/CT has obvious improved diagnosis level of malignant lesions,and has a good effect on the radiotherapy strategy and radiotherapy plans.How to exclude false positive factors should be researched further.