PET与四维CT图像结合构建胸段食管癌计划靶体积研究

发布时间：2018-06-18 02:13

本文选题：食管肿瘤 + 氟脱氧葡萄糖　；参考：《中华肿瘤防治杂志》2015年15期

【摘要】：目的比较基于三维CT(three-dimensional CT,3DCT)、四维CT(4DCT)与基于正电子发射计算机断层显像(positron emission tomograpay CT,PET-CT)结合4DCT所构建胸段食管癌原发肿瘤计划靶体积(planning target volume,PTV)位置及体积的差异性。方法选取2012-12-01-2014-02-28在山东省肿瘤医院放疗科序贯完成3DCT、4DCT和脱氧葡萄糖(fluorodeoxyglucose,FDG)PET-CT胸部定位扫描,且PET图像原发肿瘤最大标准化摄取值(maximum standardized uptake value,SUVmax)≥2.0的18例胸段食管癌患者。将3DCT图像所得大体肿瘤体积(gross tumor volume,GTV)上下方向外扩30mm,横向方向外扩5mm得到临床靶体积(clinical target volume,CTV3D);CTV3D各方向外扩10mm得到计划靶体积(planning target volume,PTV3D);内肿瘤靶体积(internal target volume,ITV4D)通过4DCT 10个时相CTV获得;将ITV4D各方向外扩5mm得到PTV4D;基于SUV≥20%SUVmax得到内生物靶体积(internal biological target volume,IBTVPET20%),将ITV4D与IBTVPET20%通过布尔逻辑运算得到ITVPET4DCT;将ITVPET4DCT各方向外扩5mm得到PTVPET4DCT。结果 PTV3D显著大于PTV4D和PTVPET4DCT,P值分别为0.001和0.044;PTVPET4DCT显著大于PTV4D,P=0.048。PTV3D对PTVPET4DCT的包含度(degree of inclusion,DI;0.70±0.05)显著大于PTV3D对PTV4D的DI(0.69±0.06),P=0.042;PTV4D对PTV3D的DI(0.96±0.03)与PTVPET4DCT对PTV3D的DI(0.95±0.03)间差异无统计学意义,P=0.118。结论在构建胸段食管癌靶区时,利用PET与4DCT图像结合不仅改变了肿瘤PTV的大小,而且改变了空间位置及其形状。将二者结合,也许能够为食管癌放疗靶区构建提供借鉴。
[Abstract]:Objective to compare the location and volume of target volume in primary esophageal carcinoma based on three-dimensional CTT (4DCT) and positron emission tomograpay CTT-CTT (PET-CTT) and positron emission tomograpay CTT-CTT (PET-CTT) combined with positron emission computed tomography (PET). Methods 18 patients with thoracic esophageal carcinoma whose chest localization scan was performed in the Department of radiotherapy, Shandong Cancer Hospital from 2012-12-01-2014-02-28 and FDGGtrofluorodeoxyglucosorticoid fluorodeoxyglucose-FDT-CT (PET-CT), and the maximum standardized uptake value of the primary tumor was maximum value of SUVmax (max2.0) were selected from 18 patients with esophageal carcinoma of thoracic segment. The gross tumor volume obtained from 3DCT images was expanded 30mm in the upper and lower directions, and the clinical target volume (CTV3D3 D) was obtained by extending 5mm in the transverse direction. The planned target volume (target volume PTV3DV) was obtained by extending the CTV3D in each direction, and the internal target volume (ITV4D) was obtained by 4DCT. PTV4D was obtained by extending 5mm in all directions, internal biological target volume of ITV4D was obtained from SUVmax, ITV4D and IBTVPET20% were obtained by Boolean logic operation, PTVPET4DCT was obtained by expanding ITVPET4DCT in each direction, PTVPET4DCT was obtained by expanding ITVPET4DCT in each direction, and ITVPET4DCT was obtained by Boolean logic operation with ITV4D and IBTVPET20% respectively. Results PTV3D was significantly larger than PTV4D and PTVPET4DCTT (P = 0.001 and 0.044) respectively. PTVPET4DCT was significantly larger than PTV4DPET0.048. PTV3D was more inclusive of PTVPET4DCT (0.70 卤0.05) than PTV3D in PTV4D (DI0.69 卤0.06P0.042PTV4D versus PTV3D). There was no significant difference between PTVPET4D and PTV3D DI0.95 卤0.03. there was no significant difference between PTV3D and PTVPET4D in PTV4D (0.96 卤0.03) and PTVPET4 (0.95 卤0.03) in PTVPET4DCT. Conclusion the combination of PET and 4DCT can not only change the size of tumor PTV, but also change the space position and shape when constructing the target area of thoracic esophageal carcinoma. The combination of the two may provide a reference for the construction of radiotherapy target for esophageal cancer.
【作者单位】：山东大学医学院;山东省肿瘤医院放疗科;
【分类号】：R735.1;R730.44

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