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目的评价局部晚期非小细胞肺癌患者,放疗前18F-FDG高代谢区能否识别放疗中及放疗后高代谢区,并探讨局部加量的最佳生物学亚靶区。方法在放疗前、放疗中(40 Gy)和/或放疗后,分别行18F-FDG PET/CT扫描。利用放疗前原发灶内40%~70%最大标准化摄取值(SUVmax),分别自动勾画相应的感兴趣区;计算放疗前感兴趣区与放疗中、放疗后高代谢区的空间重合率。分析放疗前感兴趣区体积与放疗敏感性指标的相关性。结果 50%SUVmax勾画的感兴趣区与治疗中40%SUVmax及手动勾画的高代谢区有较好的重合率,分别为(74.3±15.9)%和(84.4±15.3)%;与治疗后80%SUVmax勾画的高代谢区重合率>72%。50%SUVmax勾画的感兴趣区体积较原发灶肿瘤体积小,为(29.4±12.3)%。但50%SUVmax勾画的感兴趣区与放疗敏感性指标无相关性。结论放疗前18F-FDG-PET/CT扫描可以识别放疗中及放疗后的18F-FDG摄取区。50%SUVmax勾画的体积可能是适合加量的区域。
Objective To evaluate the ability of 18F-FDG hypermetabolites before radiotherapy to identify high-dose radiotherapy and post-radiotherapy hypermetabolites in patients with locally advanced non-small cell lung cancer (NSCLC). Methods 18F-FDG PET / CT scan was performed before radiotherapy, during radiotherapy (40 Gy) and / or after radiotherapy. The maximum normalized values (SUVmax) of 40% -70% in the primary lesions before radiotherapy were used to automatically draw the corresponding regions of interest. The spatial coincidence rates of the regions of interest prior to radiotherapy and the radiotherapy and high metabolic areas after radiotherapy were calculated. The correlation between the volume of the region of interest and radiosensitivity before radiotherapy was analyzed. Results The coincidence rates of SUVmax and hypermetabolism areas of 40% SUVmax were (74.3 ± 15.9)% and (84.4 ± 15.3)%, respectively. Compared with 80% SUVmax outlined high metabolic area coincidence rate> 72%. The volume of region of interest sketched by 50% SUVmax was (29.4 ± 12.3)% smaller than that of primary tumor. However, there was no correlation between the region of interest sketched by 50% SUVmax and the radiosensitivity index. Conclusion 18F-FDG PET / CT scan before radiotherapy can identify 18F-FDG uptake after radiotherapy and after radiotherapy. 50% SUVmax The volume outlined may be suitable for the amount of area.