CAJ | 학술논문

目的探讨肺癌患者放射治疗前后FDG PET-CT标准摄取值(SUV)及其变化在预测放射性肺炎发生中的作用.方法 40例未经手术的非小细胞肺癌(NSCLC)患者在放射治疗前后均行PET-CT检查,分别测量出受照≤5 Gy、5.1～15 Gy、15.1～35 Gy、35.1～60 Gy以及>60 Gy肺组织放射治疗前后的平均SUV,比较发生放射性肺炎组与未发生放射性肺炎组SUV的变化情况,以及受照肺组织的SUV与未受照射肺组织SUV值之比(L/B).结果 40例患者中,有8例在治疗后发生放射性肺炎,其中2级6例,3级2例.受照剂量35.1～60 Gy肺组织的SUV与放射性肺炎的发生明显相关,当SUV≥1时,放射性肺炎的发生率为41.7%,明显高于全组放射性肺炎的发生率(20.0%;X2=3.96,P<0.05),SUV预测放射性肺炎的敏感度和特异度分别为62.5%和78.1%.L/B≥2.5时,放射性肺炎的发生率为40.7%,亦明显高于全组放射性肺炎的发生率(20.0%;X2=4.92,P<0.05).以L/B≥2.5为标准预测放射性肺炎的敏感度和特异度分别为72.7%和90.9%.SUV≥1与L/B≥2.5在预测放射性肺炎发生率之间的差异无统计学意义(X2=0.002,P>0.05).结论 SUV和L/B的大小与放射性肺炎的发生呈正相关,临床医生可根据FDG PET-CT提供的SUV和L/B来预测放射性肺炎的发生.
목적 탐토폐암환자방사치료전후FDG PET-CT표준섭취치(SUV)급기변화재예측방사성폐염발생중적작용.방법 40례미경수술적비소세포폐암(NSCLC)환자재방사치료전후균행PET-CT검사,분별측량출수조≤5 Gy、5.1～15 Gy、15.1～35 Gy、35.1～60 Gy이급>60 Gy폐조직방사치료전후적평균SUV,비교발생방사성폐염조여미발생방사성폐염조SUV적변화정황,이급수조폐조직적SUV여미수조사폐조직SUV치지비(L/B).결과 40례환자중,유8례재치료후발생방사성폐염,기중2급6례,3급2례.수조제량35.1～60 Gy폐조직적SUV여방사성폐염적발생명현상관,당SUV≥1시,방사성폐염적발생솔위41.7%,명현고우전조방사성폐염적발생솔(20.0%;X2=3.96,P<0.05),SUV예측방사성폐염적민감도화특이도분별위62.5%화78.1%.L/B≥2.5시,방사성폐염적발생솔위40.7%,역명현고우전조방사성폐염적발생솔(20.0%;X2=4.92,P<0.05).이L/B≥2.5위표준예측방사성폐염적민감도화특이도분별위72.7%화90.9%.SUV≥1여L/B≥2.5재예측방사성폐염발생솔지간적차이무통계학의의(X2=0.002,P>0.05).결론 SUV화L/B적대소여방사성폐염적발생정정상관,림상의생가근거FDG PET-CT제공적SUV화L/B래예측방사성폐염적발생.
Objective To investigate the correlation of radiation pneumonitis (RP) with standardized uptake value (SUV) for fluoredeoxyglueose (FDG) positron emission tomography and computed tomography (PET-CT) in lung cancer patients treated with radiation therapy. Methods Fourty patients with unresectable non-small cell lung cancer (NSCLC) received FDG PET-CT before and after radiotherapy. The average SUV of the lung tissue irradiated with a dose of≤5 Gy, 5.1 ～ 15 Gy, 15.1 ～ 35 Gy, 35.1～ 60 Gy, > 60 Gy were measured. The correlation between SUV and RP was analyzed by comparing the SUV in the patients with RP and without. The SUV ratio of the irradiated lung tissue to that of the non-irradiated lung tissue (L/B) was also calculated. Results Of the 40 patients, 8 developed RP, including 6 eases of grade 2 and 2 cases of grade 3. The SUV of irradiated lung tissues with a dose of 35.1 ～ 60 Gy was significantly correlated with RP. When SUV ≥ 1, the RP incidence rate was 41.7% versus 20.0% in the whole group, with a statistically significant difference. (X2 = 3.96, P < 0.05 ). The sensitivity and specificity of SUV in predicting RP was 62.5% and 78.1%, respectively. When the value of L/B ≥2.5, the RP incidence rate was 40. 7% in this group versus 20. 0% in the whole group, with a statistical significance (X2 = 4.92, P < 0.05 ). If taking L/B ≥2.5 as a threshold value, the sensitivity and specificity in predicting RP was 72.7% and 90.9%, respectively. No statistically significant difference was found in predicting radiation pneumonitis between SUV≥1 and L/B≥2.5(X2 = 0.002, P>0.05). Conclusion The standardized uptake value ( SUV ) and the SUV ratio of the irradiated lung tissue to that of the non-irradiated lung tissue (L/B) for FDG PET-CT are positively correlated with radiation pneumonitis, and clinicians may use it to predict the occurrence of radiation pneumonitis.