CAJ | 학술논문

探讨PET/CT对非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC)精确放疗(Precise and AccurateRadiotherapy,PAR)计划的影响.对21例非小细胞肺癌患者行PET/CT检查,分别根据CT和PET/CT进行TNM分期,并将PET/CT图像上的TNM分期和CT分期结果进行比较分析.利用CMS治疗计划系统图像融合软件,组织5名放疗科不同年资医师分别在CT和PET/CT三维图像上独立勾画大体肿瘤体积(Gross TumorVolume,GTV_(CT)和GTV_(PET/CT)),计算患者GTV的体积值和变异系数,比较放疗科不同医师分别在CT和PET/CT上勾画GTV的差异.结果发现52.38%(11/21例)的患者TNM分期改变,21例患者GTV_(CT)和GTV_(PET/CT)均不相同.PET/CT可改变NSCLC临床分期,进而改变整个治疗计划.PET/CT可明显减小放疗科不同级别医师勾画GTV的差异.
탐토PET/CT대비소세포폐암(Non-small Cell Lung Cancer,NSCLC)정학방료(Precise and AccurateRadiotherapy,PAR)계화적영향.대21례비소세포폐암환자행PET/CT검사,분별근거CT화PET/CT진행TNM분기,병장PET/CT도상상적TNM분기화CT분기결과진행비교분석.이용CMS치료계화계통도상융합연건,조직5명방료과불동년자의사분별재CT화PET/CT삼유도상상독립구화대체종류체적(Gross TumorVolume,GTV_(CT)화GTV_(PET/CT)),계산환자GTV적체적치화변이계수,비교방료과불동의사분별재CT화PET/CT상구화GTV적차이.결과발현52.38%(11/21례)적환자TNM분기개변,21례환자GTV_(CT)화GTV_(PET/CT)균불상동.PET/CT가개변NSCLC림상분기,진이개변정개치료계화.PET/CT가명현감소방료과불동급별의사구화GTV적차이.
In order to observe impact of PET/CT on precise and accurate radiotherapy (PAR) planning of patients with non-small cell lung cancer (NSCLC), 21 patients with NSCLC had CT and FDG-hybrid PET examinations prospectively in radiation treatment position. Five radiation oncologists delineated independently the GTV including positive lymph nodes of 21 lung cancer patients on CT. The same observers delineated the GTV of the 21 patients on matched PET/CT scans. The size of GTV and coefficient of variation were used to assess inter-observer variability. The results show that all patients' GTV_(CT) differed from their GTV_(PET/CT), and the variability in the contouring of GTV_(CT) among different physicians was statistically significant (F=9.25, P<0.001), but less significant in the contouring of GTV_(PET/CT). The mean coefficient of variation for GTV based on PET/CT was significantly smaller (t= -7.46, P<0.001) than that for CT data only. It van be concluded that PET/CT may have notable impact on clinical staging of NSCLC and on its PAR planning, and will result in a reduction in this variation of the contouring of GTVs among different radiation oneologists.