CAJ | 학술논문

目的探讨平扫或强化氟脱氧葡萄精(FDG) PET-CT图像在胰腺癌靶区勾画中的作用.方法回顾分析本院2008-2009年间21例局部晚期不可切除及术后复发胰腺癌患者资料,以相同固定体位分别行平扫CT、PET,其中11例之后行强化CT.将扫描数据输入治疗计划系统,行平扫或强化CT、PET图像融合,分别依据强化CT、平扫CT、平扫PET及平扫或强化PET-CT融合图像勾画大体肿瘤体积(GTV),并用配对或成组t检验比较不同图像GTV大小.结果 21例患者平扫GTVCr、平扫GTVPET、平扫或强化GTVPET-CT平均值分别为76.9、47.0、44.5 cm3,平扫GTVPET-CT平均体积明显小于平扫GTVCT(z=-3.91,P=0.000).11例强化GTVCt、强化GTV PET、强化GTVPEr-CT平均体积分别为64.1、45.1、49.3 cm3,强化GTVPETCT平均体积明显小于强化GTVCT(z=-2.13,P=0.033),强化GTVPET-CT平均体积与平扫GTVPET-CT相似(z=-0.80,P=0.424).结论 PET和强化或平扫CT的融合图像能提高不可切除胰腺癌靶区勾画准确性,有望降低放疗不良反应.
목적 탐토평소혹강화불탈양포도정(FDG) PET-CT도상재이선암파구구화중적작용.방법 회고분석본원2008-2009년간21례국부만기불가절제급술후복발이선암환자자료,이상동고정체위분별행평소CT、PET,기중11례지후행강화CT.장소묘수거수입치료계화계통,행평소혹강화CT、PET도상융합,분별의거강화CT、평소CT、평소PET급평소혹강화PET-CT융합도상구화대체종류체적(GTV),병용배대혹성조t검험비교불동도상GTV대소.결과 21례환자평소GTVCr、평소GTVPET、평소혹강화GTVPET-CT평균치분별위76.9、47.0、44.5 cm3,평소GTVPET-CT평균체적명현소우평소GTVCT(z=-3.91,P=0.000).11례강화GTVCt、강화GTV PET、강화GTVPEr-CT평균체적분별위64.1、45.1、49.3 cm3,강화GTVPETCT평균체적명현소우강화GTVCT(z=-2.13,P=0.033),강화GTVPET-CT평균체적여평소GTVPET-CT상사(z=-0.80,P=0.424).결론 PET화강화혹평소CT적융합도상능제고불가절제이선암파구구화준학성,유망강저방료불량반응.
Objective To investigate the application of non-contrast and contrast-enhanced 18FDG PET/CT in the delineation of gross tumor volume ( GTV ) of pancreatic cancer.Methods Between Jan.2008 and Dec.2009,twenty-one patients with unresectable locally advanced pancreatic cancer or recurrent pancreatic cancer after surgery in our hospital had both non-contrast CT and PET images acquired at the same body position.Among the whole group,eleven patients also had contrast CT images.The image data sets were transferred to the treatment planning workstation for registration.Then gross tumor volumes ( GTV )were delineated independently using the information of PET images,contrast/non-contrast CT scan and contrast/non-contrast PET-CT fusion images.The differences of mean volume in these different sets of GTV were analyzed.Results For the whole group,the mean volume of non-contrast GTVCT,GTVPET,noncontrast GTVPET-CT were 76.9 cm3,47.0 cm3 and 44.5 cm3,respectively.The mean volume of non-contrast GTVPET-CT was significantly smaller than non-contrast GTVCT ( z =-3.91,P =0.000 ).For the eleven patients with contrast CT,the mean volume of contrast GTVCT,GTVPET,contrast GTVPET-CT were 64.1 cm3,45.1 cm3 and 49.3 cm3,respectively.The mean volume of contrast GTVPET-CT was significantly smaller than contrast GTVCT (z =-2.13,P =0.033 ).No significant differences were found between contrast PET-CT and non-contrast PET-CT (z =-0.80,P =0.424).Conclusions Co-registration of PET and contrast/noncontrast CT information in pancreatic cancer may improve the accuracy of GTV delineation,and possibly reduce the adverse effect of irradiation.