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目的探讨18F脱氧葡萄糖正电子发射断层扫描-计算机断层扫描(18F-FDG-PET-CT)在胶质瘤三维适形放疗中的应用价值。方法本院从2008年1月~2009年12月收治的20例胶质瘤病人,均行三维适形放疗,手术前后均行磁共振T1 WI平扫和增强扫描,T2 WI平扫扫描,术后行18F-FDG-PET脑显像,根据磁共振和18F-FDG-PET显示的病变范围勾画显在肿瘤区、临床肿瘤区及计划肿瘤区。计划肿瘤区DT:54～60Gy。结果放疗后3月复查磁共振,根据RECIST标准评价疗效,完全缓解率(CR):10.0%(2/20),部分缓解率(PR):35.0%(7/20),稳定(SD):40%(8/20),进展(PD):15%(3/20)。胶质瘤残灶标准摄取值(SUV)与对侧白质SUV值比值(RT/WM SUV)与病理分级呈显著正相关,r=0.770,P=0.001。结论 18F-FDG-PET脑显像对于胶质瘤三维适形放疗的靶区勾画具有一定的临床价值。
Objective To investigate the value of 18F-FDG PET-CT in the three-dimensional conformal radiotherapy of gliomas. Methods Twenty patients with glioma admitted to our hospital from January 2008 to December 2009 underwent three-dimensional conformal radiotherapy. Before and after the operation, magnetic resonance T1 WI scan and enhanced scan were performed. T2 WI scan was performed. Follow-up 18F-FDG-PET brain imaging, based on magnetic resonance and 18F-FDG-PET lesions showed outlined in the tumor area, clinical tumor area and planned tumor area. Plan tumor area DT: 54 ~ 60Gy. Results The MRI was reviewed 3 months after radiotherapy and the response was evaluated according to RECIST criteria. The complete response rate (CR) was 10.0% (2/20), partial response rate (PR) was 35.0% (7/20), and stable (SD) 40% (8/20), progress (PD): 15% (3/20). There was a significant positive correlation between pathological grade and the ratio of standard in-sutural value (SUV) to contralateral white matter (RT / WM SUV) of gliomas, r = 0.770, P = 0.001. Conclusion 18F-FDG-PET brain imaging for glioma three-dimensional conformal radiotherapy target area has some clinical value.