Belkacémi Yazid, Lartigau Eric, Kerrou Khaldoun, Carpentier Philippe, Taïeb Sophie, Giraud Philippe
CRLCC Oscar-Lambret, Département universitaire d'oncologie-radiothérapie, 3 rue Frédéric-Combemale, 59020 Lille.
Bull Cancer. 2007 Jan;94(1):99-108.
Advances in medical imaging have greatly enhanced the speciality of radiation oncology by allowing more healthy tissue to be speared for better tumour coverage. Positron emission tomography (PET) with the glucose analogue [18F]-fluoro-2-deoxy-D-glucose (FDG) is a functional imaging method that has become widely used in oncology over the last decade. It has been rapidly incorporated in the staging and treatment planing of many patients with cancer in several anatomic sites such as non-small cell lung carcinomas. However, the initial data were controversial by the use of non dedicated PET units, the lack of patient immobilisation for radiation therapy, or the lack of image registration for fusion PET images with computed tomography (CT). The increased number of combined PET/CT units installed and the development of new isotopes that allow advances in biological and molecular tumour and healthy tissue imaging should lead to enhanced target definition for highly conformal radiation therapy. Such developments might also allow tumour viability or healthy tissue function to be imaged, which could be used during treatment as early indicators of tumour response or healthy tissue injury, possibly leading to a change in treatment strategy based on functional and biological imaging. The contribution of PET imaging advances using FDG or new tracers for treatment planing in the new era of image guided radiation therapy will be discussed in this review.
医学成像技术的进步极大地提升了放射肿瘤学专业水平，因为它能使更多健康组织得以保留，从而实现更好的肿瘤覆盖。正电子发射断层扫描（PET）结合葡萄糖类似物[18F]-氟-2-脱氧-D-葡萄糖（FDG）是一种功能成像方法，在过去十年中已在肿瘤学领域广泛应用。它已迅速被纳入许多癌症患者的分期和治疗计划中，这些癌症分布于多个解剖部位，如非小细胞肺癌。然而，最初的数据存在争议，原因包括使用非专用PET设备、缺乏用于放射治疗的患者固定装置，或者缺乏将PET图像与计算机断层扫描（CT）图像融合的图像配准。安装的PET/CT联合设备数量增加，以及新同位素的开发，这些新同位素推动了生物和分子层面的肿瘤及健康组织成像的发展，有望为高度适形放射治疗提供更精确的靶区定义。这些进展还可能实现肿瘤活性或健康组织功能的成像，在治疗过程中可作为肿瘤反应或健康组织损伤的早期指标，可能会基于功能和生物成像改变治疗策略。本综述将探讨在图像引导放射治疗新时代，使用FDG或新示踪剂的PET成像进展对治疗计划的贡献。
