Daisne Jean-François, Grégoire Vincent
Service de radiothérapie oncologique et Unité d'imagerie moléculaire et de radiothérapie expérimentale (IMRE), Cliniques universitaires Saint-Luc, avenue Hippocrate, 10, B-1200 Bruxelles, Belgique.
Bull Cancer. 2006 Dec;93(12):1175-82.
Modern radiotherapy delivery nowadays relies on tridimensional, conformal techniques. The aim is to better target the tumor while decreasing the dose administered to surrounding normal tissues. Gold standard imaging modality remains computed-tomography (CT) scanner. However, the intrinsic lack of contrast between soft tissues leads to high variabilities in target definition. The risks are : a geographical miss with tumor underirradiation on the one hand, and a tumor overestimation with undue normal tissues irradiation on the other hand. Alternative imaging modalities like magnetic resonance imaging and functional positron emission tomography could theoretically overcome the lack of soft tissues contrast of CT. However, the fusion of the different imaging modalities images requires the use of sophisticated computer algorithms. We will briefly review them. We will then review the different clinical results reported with multi-modalities imaging for tumors of the head, neck, lung, esophagus, cervix and lymphomas. Finally, we will briefly give practical recommendations for multi-modality imaging in radiotherapy treatment planning process.
如今,现代放射治疗依赖于三维适形技术。其目的是在减少对周围正常组织所施剂量的同时,更好地靶向肿瘤。金标准成像方式仍然是计算机断层扫描(CT)扫描仪。然而,软组织之间固有的对比度不足导致靶区定义存在很大差异。风险在于:一方面存在肿瘤照射不足的几何遗漏,另一方面存在对正常组织过度照射导致的肿瘤高估。诸如磁共振成像和功能正电子发射断层扫描等替代成像方式理论上可以克服CT软组织对比度不足的问题。然而,不同成像方式图像的融合需要使用复杂的计算机算法。我们将简要回顾它们。然后,我们将回顾对头颈部、肺部、食管、宫颈肿瘤及淋巴瘤采用多模态成像所报告的不同临床结果。最后,我们将简要给出放射治疗治疗计划过程中多模态成像的实用建议。