分析FDG PET-CT与MRI影像组数在口咽鳞癌术后精确放疗的应用价值

doi:10.3760/cma.j.issn.1004-4221.2017.08.003

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摘要目的分析¹⁸FDG PET-CT与MRI在口咽鳞癌术后精确放疗中应用价值。方法 53例口咽鳞癌患者在术后2周内行PET-CT与MRI检查,以病理活检结果作为判断标准对比二者在术后残存病灶及淋巴结转移方面的阳性检出率,并比较基于PET-CT与MRI确定的肿瘤靶区及临床靶区体积之间的差异性。结果 14例患者术后残留,PET-CT诊断的敏感性、特异性、阳性预测值、阴性预测值及准确率为92.86%、94.87%、86.67%、97.37%、94.34%,MRI为57.14%、76.92%、47.06%、83.34%、71.70%,在诊断阳性淋巴结方面各值PET-CT均高于MRI (P均<0.05),但在敏感性及阴性预测值方面相近(P均>0.05)。14例存在术后残留患者,GTV_PET-CT为(45.62±22.13) cm³,GTV_MRI为(60.61±23.12) cm³(P=0.034);CTV_PET-CT为(125.54±17.53) cm³,CTV_MRI为(142.18±21.22) cm³(P=0.011)。39例无术后残存患者术区及高危区照射体积CTV_PET-CT为(117.87±17.66) cm³,CTV_MRI为(128.05±20.65) cm³(P=0.099)。

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	黄蓉
	吴慧
	徐靖
	卢晓旭
	孙学明
	王姝娟

关键词 ：口咽肿瘤/放射疗法, 对比分析, 影像组学

Abstract： Objective To investigate the clinical values of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸FDG PET-CT) and magnetic resonance imaging (MRI) in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma. Methods A total of 53 patients with oropharyngeal squamous cell carcinoma were enrolled and underwent PET-CT and MRI imaging within two weeks after surgery. The detection rates of residual lesions and lymph node metastases after surgery by PET-CT and MRI were compared on the basis of the pathological results of biopsy. The gross tumor volume (GTV) and clinical target volume (CTV) determined by PET-CT and MRI were compared;the normally distributed data were analyzed using the t test, and the skewed distribution data by the Wilcoxon rank sum test. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in predicting precise radiotherapy after surgery, as determined by PET-CT and MRI, were compared with the chi-square test. Results Fourteen patients had residual lesions after surgery. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET-CT in detecting residual lesions after surgery were significantly higher than those of MRI (92.86%, 94.87%, 86.67%, 97.37%, and 94.34% vs. 57.14%, 76.92%, 47.06%, 83.34%, and 71.70%, all P<0.05);the specificity, positive predictive value, and accuracy of PET-CT in detecting lymph node metastases were also significantly higher than those of MRI (all P<0.05), except for the sensitivity and negative predictive value (P>0.05). For the 14 patients with residual lesions, GTV_PET/CT was significantly smaller than GTV_MRI(45.62±22.13 cm³ vs. 60.61±23.12 cm³, P=0.034), so did CTV (125.54±17.53 cm³ vs. 142.18±21.22 cm³, P=0.011). There was no significant difference between CTV_PET-CT and CTV_MRI in 39 patients without residual lesions after surgery (117.87±17.66 cm³ vs. 128.05±20.65, P=0.099). Conclusions PET-CT is superior to MRI in detecting the residual lesions and lymph node metastases after surgery in patients with oropharyngeal squamous cell carcinoma, which provides valuable information for radiotherapy planning.

Key words： Oropharyngeal neoplasms/radiotherapy Contrastive analysis Radiomics

收稿日期: 2017-01-18

通讯作者: 吴慧,Email:wuhui7008@126.com

引用本文:

黄蓉,吴慧,徐靖等. 分析FDG PET-CT与MRI影像组数在口咽鳞癌术后精确放疗的应用价值[J]. 中华放射肿瘤学杂志, 2017, 26(8): 857-861.

Huang Rong,Wu Hui,Xu Jing et al. Clinical values of ¹⁸FDG PET-CT and MRI in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2017, 26(8): 857-861.

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