CAJ | 학술논문

目的探讨PET-CT对左侧乳腺癌术后放疗患者左心室(LV)显示和心脏亚结构[LV及左侧冠状动脉前降支(LAD)]勾画,以及心脏、心脏亚结构放疗剂量体积间关系.方法 2008-2009年间14例左侧乳腺癌患者进入本研究,放疗前接受氟脱氧葡萄糖PET-CT LV心肌显像扫描,继而用ADAC Pinnacle37.6c计划系统与增强定位CT融合.LV在PET-CT图像上勾画,LAD的勾画参考前室间隔解剖及增强CT图像.放疗计划采用6个野简化调强放疗(sIMRT)技术,并用Pearson法分析sIMRT下心脏与亚结构接受≥50%处方剂量(25 Gy)的体积占总体积百分比(V25)间关系.结果 14例患者PET-CT图像勾画的LV体积(LV-PET)均值为112.931 cm3.心脏V25与LV-PET V25间呈正相关(R=0.869,P=0.000),心脏V25与LAD-CTVV间无关(R=0.220,P=0.440).结论对左侧乳腺癌患者以PET-CT LV代谢显像为基础能有效勾画LV解剖结构,sIMRT计划显示了心脏与其亚结构的剂量体积间关系,为进一步分析这些正常组织的放射损伤提供了量化的基础和可能.
목적 탐토PET-CT대좌측유선암술후방료환자좌심실(LV)현시화심장아결구[LV급좌측관상동맥전강지(LAD)]구화,이급심장、심장아결구방료제량체적간관계.방법 2008-2009년간14례좌측유선암환자진입본연구,방료전접수불탈양포도당PET-CT LV심기현상소묘,계이용ADAC Pinnacle37.6c계화계통여증강정위CT융합.LV재PET-CT도상상구화,LAD적구화삼고전실간격해부급증강CT도상.방료계화채용6개야간화조강방료(sIMRT)기술,병용Pearson법분석sIMRT하심장여아결구접수≥50%처방제량(25 Gy)적체적점총체적백분비(V25)간관계.결과 14례환자PET-CT도상구화적LV체적(LV-PET)균치위112.931 cm3.심장V25여LV-PET V25간정정상관(R=0.869,P=0.000),심장V25여LAD-CTVV간무관(R=0.220,P=0.440).결론 대좌측유선암환자이PET-CT LV대사현상위기출능유효구화LV해부결구,sIMRT계화현시료심장여기아결구적제량체적간관계,위진일보분석저사정상조직적방사손상제공료양화적기출화가능.
Objective To evaluate the volume of left ventricle (LV) based on PET-CT in left-sided breast cancer patients treated with adjuvant radiotherapy. To assess the impact of dose and volume in interrelations for heart and cardiac sub-structures using dose-volume histograms. Methods From October 2008 to February 2009, 14 patients with post-operatively confirmed left-sided breast cancer were enrolled in this study. Patients were scanned using contrast enhanced CT for simulation and FDG PET-CT have been applied to display the structure of left ventricle in each patient before radiotherapy (RT). The LV has been delineated based on PET-CT. Other critical sub-structures, such as left anterior descending coronary artery (LAD) have been contoured in each patient. The six-field simple intensity modulated radiotherapy (slMRT)technique has been created in all patients. Results The mean volumes of left ventricle based on PET-CT (LV-PET) were 112. 931 cm3. The volume of LV receiving ≥50% prescription dose highly correlated with the volume of heart receiving ≥50% prescription dose (R = 0. 869, P = 0. 000). There was less correlation between the volume of LAD and the volume of heart receiving ≥ 50% prescription dose ( R = 0. 220, P =0. 440). Conclusions The left ventricle could be delineated efficiently based on imaging of PET-CT. The volume of LV receiving higher dose in RT has high correlation with the volume of heart using sIMRT technique. It may pave the way for further exploring radiation induced cardiac injury in patients with breast cancer.