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目的通过18-F-氟代脱氧葡萄糖正电子发射型计算机断层扫描仪(18F-FDG PET/CT)代谢体积、增强CT体积及病理体积的对比,探索功能代谢影像是否较解剖影像对于宫颈癌靶区的勾画更具优势。方法 12例宫颈癌患者术前行PET/CT和增强CT扫描,PET图像选取肿瘤最大标准化摄取值(SUV max)的40%阈值勾画肿瘤边界,生成相应PET的大体肿瘤体积(PET GTV)。增强CT图像按照增强边缘进行勾画,所得体积作为CT的大体肿瘤体积(CT GTV)。术后进行病理切片,确定每层切片肿瘤边缘及面积,面积乘以切片厚度计算每张切片的肿瘤体积,累积所有切片的肿瘤体积为全部肿瘤的病理大体体积(病理GTV)。比较PET GTV、CT GTV及病理体积的差异。结果 12例患者SUVmax 40%阈值勾画肿瘤边界所得PET GTV与病理GTV比较,差异无统计学意义(P=0.352),并且两者有较好的相关性(r=0.99,P<0.01)。CT所确定的体积较病理GTV大,仅1例与病理GTV相似,其余11例CT GTV大于病理GTV,最大者为病理GTV的5倍余。PET GTV与CT GTV相关性较差(r=0.70,P=0.816)。结论在宫颈癌的影像学检查中,对于肿瘤靶区的勾画PET/CT优于增强CT。
OBJECTIVE: To compare the metabolic volume of 18F-FDG PET / CT and contrast volume and pathological volume of 18F-FDG PET / CT to explore whether functional metabolic imaging is more effective than cervical dissection District outlined more advantages. Methods Twelve patients with cervical cancer underwent preoperative PET / CT and enhanced CT scans. The 40% threshold of the maximal normalized tumor uptake value (SUV max) in PET images was used to map the tumor boundary to generate the corresponding PET gross tumor volume (PET GTV). Enhanced CT images are outlined with enhanced edges and the resulting volume is taken as the gross tumor volume of CT (CT GTV). After the operation, the pathological sections were taken and the edge and area of each slice were determined. The area of each slice was multiplied by the slice thickness to calculate the tumor volume of each slice. The tumor volume accumulated in all the slices was the gross pathological volume (pathological GTV) of all the tumors. Compare PET GTV, CT GTV and pathological volume differences. Results There was no significant difference in the GTV between the PET GTV and the pathological GTV at the 40% SUVmax threshold (P = 0.352). There was a good correlation between the two (r = 0.99, P <0.01). The volume determined by CT was larger than that of pathological GTV, only 1 case was similar to pathological GTV. The other 11 cases of CT GTV were larger than pathological GTV, and the largest was more than 5 times of pathological GTV. The correlation between PET GTV and CT GTV was poor (r = 0.70, P = 0.816). Conclusion In the imaging examination of cervical cancer, the PET / CT mapping of tumor target area is superior to enhanced CT.