CAJ | 학술논문

目的对比研究FDG PET-CT不同勾画方法间及与MRI显示鼻咽原发灶靶区差异,探讨FDG PET-CT勾画鼻咽原发灶大体肿瘤体积(GTV)生物靶区的可行性.方法 50例初治鼻咽癌患者治疗前均行FDG PET-CT和MRI检查,先在MRI图像上勾画GTV得到GTV-MRI,然后在FDGPET-CT上分别用目测法或不同阈值法(30％、40％、50％ SUVmax)勾画GTV得到GTV-PETvis、GTV-PET30、GTV-PET40、GTV-PET50.采用Wilcoxon检验GTV-PET不同方法间和GTV-MRI差异,以及不同T分期中不同勾画方法间差异.结果全组GTV-MRI、GTV-PETvis、GTV-PET30、GTV-PET40、GTV-PET50分别为27.8、22.2、22.7、14.4、9.0 cm3,除GTV-PETvis与GTV-PET30间(Z=-0.05,P=0.958)以及T1～2期(25例)GTV-MRI与GTV-PETvis和GTV-PET30相似外(Z=-0.93、-0.93,P=0.353、0.353),其余均不同(Z=-5.74～-2.09,P=0.000～0.037).结论应用FDG PET-CT不同方法勾画的GTV-PET均＜GTV-MRI.FDG PET-CT目测法或以30％ SUVmax为阈值自动勾画鼻咽原发灶GTV可实现生物代谢肿瘤体积范围勾画.
목적 대비연구FDG PET-CT불동구화방법간급여MRI현시비인원발조파구차이,탐토FDG PET-CT구화비인원발조대체종류체적(GTV)생물파구적가행성.방법 50례초치비인암환자치료전균행FDG PET-CT화MRI검사,선재MRI도상상구화GTV득도GTV-MRI,연후재FDGPET-CT상분별용목측법혹불동역치법(30％、40％、50％ SUVmax)구화GTV득도GTV-PETvis、GTV-PET30、GTV-PET40、GTV-PET50.채용Wilcoxon검험GTV-PET불동방법간화GTV-MRI차이,이급불동T분기중불동구화방법간차이.결과 전조GTV-MRI、GTV-PETvis、GTV-PET30、GTV-PET40、GTV-PET50분별위27.8、22.2、22.7、14.4、9.0 cm3,제GTV-PETvis여GTV-PET30간(Z=-0.05,P=0.958)이급T1～2기(25례)GTV-MRI여GTV-PETvis화GTV-PET30상사외(Z=-0.93、-0.93,P=0.353、0.353),기여균불동(Z=-5.74～-2.09,P=0.000～0.037).결론 응용FDG PET-CT불동방법구화적GTV-PET균＜GTV-MRI.FDG PET-CT목측법혹이30％ SUVmax위역치자동구화비인원발조GTV가실현생물대사종류체적범위구화.
Objective To compare gross tumor volume (GTV) of nasopharyngeal carcinoma (NPC) according to MRI and FDG PET/CT and to investigated four fixed threshold methods to delineate the GTV using FDG PET/CT.Methods Fifty patients with primary biopsy-proven NPC were prospectively were enrolled into the study.FDG PET/CT scans and MRI were carried out within one week prior to pretreatment,respectively.The GTV was named GTV-MRI (GTV were delineated according to MRI),GTV-PETvis,GTV-PET30,GTV-PET40,GTV-PET50 (GTV was delineated according to the PET-based GTVs obtained by visual interpretationor,by percentage of the SUVmax (30％,40％,50％) thresholds,respectively).The differences were compared among the GTV-MRI,GTV-PETvis,GTV-PET30,GTV-PET40 and GTV-PET50 in different by Wilcoxon test.Results Of 50 patients,the median of volume descending order were: GTV-MRI 27.8 cm3,GTV-PETvis 22.2 cm3,GTV-PET30 22.7 cm3,GTV-PET40 14.4 cm3 and GTV-PET50 9.0 cm3.However,there was no significant difference between GTV-PETvis and GTV-PET30 (Z=-0.05,P=0.958),as well as GTV-MRI and GTV-PETvis or GTV-PET30 in 25 patients who were T1-2 stage (Z =-0.93,-0.93,P=0.353,O.353),the other GTVs were all different in 50 patients' (Z=-5.74-2.09,P =0.000-0.037).Conclusions All the GTVs delineated by the different methods of using FDG PET/CT were less than the GTV delineated by MRI.The potential advantages with the GTV-PETvis or GTV-PET30 delineated by FDG PET/CT are reduction of biological metabolic tumor volume in GTV delineation and reduction of the size of the GTV in NPC patients.