3DCT、4DCT和PET-CT定义的胸段食管癌PTV比较研究

doi:10.3760/cma.j.issn.1004-4221.2015.05.005

摘要
图/表
参考文献()
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (344 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的探讨基于PET-CT图像SUV≥2.5、20%或25%SUV_max与基于3DCT、4DCT构建的胸段食管癌PTV位置及体闫积差异性。方法 18例胸段食管癌患者序贯完成3DCT、4DCT、FDG PET-CT 胸部定位扫描。3DCT图像常规外扩获得PTV_3D;PTV_4D通过10个时相靶区融合获得;基于SUV≥2.5、20%或25%SUV_max分别得到IGTV_PET2.5、IGTV_PET20%、IGTV_PET25%,分别将这3个靶区上下方向外扩3.5 cm,左右前后方向外扩1 cm得到PTV_PET2.5、PTV_PET20%、PTV_PET25%。结果 PTV_3D体积显著大于PTV_4D和PTV_PET(P=0.000~0.044),而PTV_PET和PTV_4D相近(P=0.216~0.633)。PTV_3D、PTV_4D相互间DI分别为0.70、0.95,同三维运动矢量呈负相关(P=0.039)。PTV_PET2.5、PTV_PET20%、PTV_PET25%相互间DI分别为0.74、0.72、0.78、0.73、0.77、0.70,同三维运动矢量无相关性(P=0.150~0.822)。PTV_3D、PTV_PET间相互DI分别为0.86、0.84、0.88、0.63、0.67、0.59。结论由于各自所包含的靶区信息差异等原因,基于3DCT、4DCT及PET-CT构建的胸段食管癌PTV在空间上很难达到完全重合。利用自由呼吸状态下PET扫描图像来构建胸段食管癌PTV尚需慎重。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	郭延娈
	李建彬
	李彦康
	王玮
	马志芳
	梁超前
	邢军
	段益利

关键词 ：体层摄影术, X线计算机, 三维, 体层摄影术, X线计算机, 四维, 体层摄影术, 正电子发射, 氟脱氧葡萄糖, 计划靶体积, 食管肿瘤/放射疗法

Abstract：Objective To investigate the differences in position and volume between planning target volumes (PTV) based on positron emission tomography-computed tomography (PET-CT) images with an standardized uptake value (SUV) no less than 2.5, 20% of the maximum SUV (SUV_max), or 25% of SUV_max, three-dimensional (3D) CT, and four-dimensional (4D) CT in thoracic esophageal cancer. Methods Eighteen patients with thoracic esophageal cancer sequentially received chest 3DCT, 4DCT, and[18F]fluoro-2-deoxy-D-glucose (FDG) PET-CT scans. PTV_3D was obtained by conventional expansion of 3DCT images;PTV_4D was obtained by fusion of target volumes from 10 phases of 4DCT images. The internal gross tumor volumes (IGTV), IGTV_PET2.5, IGTV_PET20%, and IGTV_PET25%, were generated based on PET-CT images with an SUV no less than 2.5, 20% of SUV_max, and 25% of SUV_max, respectively. These IGTVs were expanded longitudinally by 3.5 cm and radically by 1 cm to make PTV_PET2.5, PTV_PET20%, and PTV_PET25%, respectively. Results PTV_3D was significantly larger than both PTV_4D and PTV_PET(P=0.000－0.044), while there was no significant difference between PTV_4D and PTV_PET(P=0.216－0.633). The mutual degrees of inclusion (DIs) between PTV_3D and PTV_4D were 0.70 and 0.95, respectively, which were negatively correlated with 3D-Vector (P=0.039). The mutual DIs between PTV_PET2.5, PTV_PET20%, and PTV_PET25% were 0.74, 0.72, 0.78, 0.73, 0.77, and 0.70, respectively, which showed no correlation with 3D-Vector (P=0.150－0.822). The mutual DIs between PTV_3D and PTV_PET were 0.86, 0.84, 0.88, 0.63, 0.67, and 0.59, respectively. Conclusions It is difficult to achieve complete volumetric overlap of PTVs based on 3DCT, 4DCT and PET-CT in thoracic esophageal cancer due to different target volume information. PET scan during free breathing should be used with caution to generate PTVs in thoracic esophageal cancer.

Key words： Tomography,X-ray computed,three-dimensional Tomography,X-ray computed,four-dimensional Tomography, positron-emission, fluorodeoxyglucose Planning target volume Esophageal neoplasms/radiotherapy

通讯作者: 李建彬,E-mail:lijianbin@msn.com

引用本文:

郭延娈,李建彬,李彦康等. 3DCT、4DCT和PET-CT定义的胸段食管癌PTV比较研究[J]. 中华放射肿瘤学杂志, 2015, 24(5): 497-501.

Guo Yanluan,Li Jianbin,Li Yankang et al. A comparative study of planning target volumes based on three-dimensional computed tomography, four-dimensional computed tomography, and positron emission tomography-computed tomography in thoracic esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2015, 24(5): 497-501.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2015.05.005 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2015/V24/I5/497

[1] 王金之,张英杰,李建彬,等.放疗中食管癌原发肿瘤靶区位移及其影响[J].中华肿瘤杂志,2013,35(8):561-565.DOI:10.3760/cma.j.issn.0253-3766.2013.08.001.
[2] 王玮,李建彬,张英杰,等.三维CT与四维CT确定胸段食管癌计划靶体积比较研究[J].中华放射肿瘤学杂志,2013,22(1):22-25.DOI:10.3760/cma.j.issn.1004-4221.2013.01.007.
[3] Cole AJ,O′Hare JM,McMahon SJ,et al. Investigating the potential impact of four-dimensional computed tomography (4DCT) on toxicity,outcomes and dose escalation for radical lung cancer radiotherapy[J].Clin Oncol,2014,26(3):142-150.DOI:10.1016/j.clon.2013.11.024.
[4] 谢彦婷,郑容.¹⁸F-FDG PET-CT在食管癌放疗中的应用[J].中华放射肿瘤学杂志,2013,37(1):42-46.DOI:10.3760/cma.j.issn.1673-4114.2013.01.012.
[5] Guo Y,Li J,Wang W,et al. Geometrical differences in target volumes based on ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography and four-dimensional computed tomography maximum intensity projection images of primary thoracic esophageal cancer[J].Diseases of the Esophagus,2014,27(8):744-750.DOI:10.1111/dote.12247.
[6] Yaremko B,Riauka T,Robinson D,et al. Thresholding in PET images of static and moving targets[J].Phys Med Biol,2005,50(24):5969-5982.DOI:10.1088/0031-9155/50/24/014.
[7] Hof H,Rhern B,Haering P,et al.4D-CT-based target volume definition in stereotactic radiotherapy of lung tumors:Comparison with a conventional technique using individual margins[J].Radiother Oncol,2009,93(3):419-423.DOI:10.1016/j.radonc.2009.08.040.
[8] Chen Y,Chen X,Li F,et al. Delineation gross tumor volume based on positron emission tomography images by a numerical approximation method[J].Ann Nucl Med,2014,28(10):980-985.DOI:10.1007/s12149-014-0894-x.
[9] Muijs CT,Schreurs LM,Busz DM,et al. Consequences of additional use of PET information for target volume delineation and radiotherapy dose distribution for esophageal cancer[J].Radiother Oncol,2009,93(3):447-453.DOI:10.1016/j.radonc.2009.08.030.
[10] Caldwell CB,Mah K,Skinner M,et al. Can PET provide the 3D extent of tumor motion for individualized internal target volumes？ A phantom study of the limitation of CT and the promise of PET[J].Int J Radiat Oncol Biol Phys,2003,55(5):1381-1393.DOI:10.1016/S0360-3016(02)04609-6.
[11] 郭延娈,李建彬,张英杰,等.4DCT全时相与PET-CT不同SUV阈值勾画胸段食管癌IGTV的比较研究[J].中华放射肿瘤学杂志,2013,23(3):226-230.DOI:10.3760/cma.j.issn.1004-4221.2014.03.013.
[12] Muijs CT,Beukema JC,Pruim J,et al. A systematic review on the role of FDG-PET-CT in tumour delineation and radiotherapy planning in patients with esophageal cancer[J].Radiother Oncol,2010,97(2):165-171.DOI:10.1016/j.radonc.2010.04.024.
[13] Callahan J,Kron T,Schneider-Kolsky M,et al. The clinical significance and management of lesion motion due to respiration during PET-CT scanning[J].Cancer Imaging,2011,11(1):224-236.DOI:10.1102/1470-7330.2011.0031.