基于DWI及<sup>18</sup>F-FDG PET-CT勾画胸段食管癌大体肿瘤体积变化与比较

doi:10.3760/cma.j.cn113030-20210209-00069

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Abstract Objective To evaluate the spatial position and functional parameters of¹⁸F-FDG PET-CT and diffusion-weighted imaging (DWI) before and during radiotherapy (RT) based on the medium of 3DCT in patients with esophageal cancer and to explore whether the high-signal area derived from DWI can be used for individualized definition of the volume in need of dose-escalation for esophageal cancer. Methods Thirty-two patients with esophageal cancer treated with concurrent chemoradiotherapy or neoadjuvant chemoradiation sequentially underwent repeated 3DCT,¹⁸F-FDG PET-CT and enhanced MRI scans before RT and at the 15^th time of RT. All images were fused with the 3DCT images by deformable registration. The gross tumor volume (GTV) was delineated based on PET Edge on the first and second 3DCT, PET-CT and DWI and corresponding T2-weighted MRI (T2W-MRI) fused images, and defined as GTVCTpre and GTVCTdur, GTVPETpre, GTVPETdur, GTVDWIpre and GTVDWIdur,respectively. SUV (SUVmax, SUVmean,SUVpeak), MTV, TLG, ADC (ADCmin and ADCmean) values and △SUV (△SUVmax, △SUVmean, △SUVpeak), △MTV, △TLG,△ADC (△ADCmean and △ADCmin) of lesions were measured before and during RT. Results The differences in SUV (SUVmax, SUVmean, SUVpeak), MTV, TLG, ADCmean and ADCmin of the GTV before and during RT were statistically significant (all P<0.001). The tumor ADC and SUV values before and during RT showed no significant correlation, and there was no correlation between △ADC and △SUV (both P>0.05). The conformity index (CI) of GTVPETpre to GTVDWIpre was significantly higher than that of GTVPETdur to GTVDWIdur (P<0.001). The shrinkage rate of maximum diameter (△LDDWI)(24%) and the shrinkage rate of tumor volume (VRRDWI)(60%) based on DWI during RT were significantly greater than the corresponding PET-based △LDPET (14%) and VRRPET (41%)(P=0.017 and P<0.001). Conclusions The location of high residual FDG uptake based on PET-CT yields poor spatial matching compared with the area with residual high signal based on DWI during RT. Tumor ADC and SUV values may play complementary roles as imaging markers for prediction of patterns of failure and for definition of the volume in need of dose-escalation. In addition, the shrinkage rates of tumor maximum diameter/volume based on DWI during RT are significantly faster than those based on PET-CT. Therefore, the feasibility of selecting boosting of the high signal area derived from DWI for individualized definition of the volume for esophageal cancer is not clear.

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	Li Huimin
	Li Jianbin
	Li Fengxiang
	Zhang Yingjie
	Li Yankang
	Guo Yanluan
	Xu Liang

Key words： Diffusion-weighted imaging Tomography, positron emission-X-ray computed Gross tumor volume Esophageal neoplasm/dose escalation irradiation

Received: 09 February 2021

ZTFLH:

Fund:National Natural Science Foundation of China (81773287);Taishan Scholars Program of Shandong Province (ts20190982)

Corresponding Authors: Li Jianbin, Email:lijianbin@msn.com;Li Fengxiang, Email:lifengxiangli@aliyun.com

Cite this article:

Li Huimin,Li Jianbin,Li Fengxiang et al. Comparison of spatial location and dynamic changes of functional parameters of primary tumors of thoracic esophageal cancer based on DWI and ¹⁸F-FDG PET-CT before and during radiotherapy[J]. Chinese Journal of Radiation Oncology, 2021, 30(12): 1238-1243.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20210209-00069 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I12/1238

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