Aerts Hugo J W L, Bosmans Geert, van Baardwijk Angela A W, Dekker Andre L A J, Oellers Michel C, Lambin Philippe, De Ruysscher Dirk
Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, University Hospital Maastricht, Dr. Tanslaan 12, Maastricht, The Netherlands.
Int J Radiat Oncol Biol Phys. 2008 Aug 1;71(5):1402-7. doi: 10.1016/j.ijrobp.2007.11.049. Epub 2008 Jan 30.
Because individual tumors are heterogeneous, including for (18)F-deoxyglucose (FDG) uptake and, most likely, for radioresistance, selective boosting of high FDG uptake zones within the tumor has been suggested. To do this, it is critical to know whether the location of these high FDG uptake patterns within the tumor remain stable during radiotherapy (RT).
Twenty-three patients with Stage I-III non-small-cell lung cancer underwent repeated FDG positron emission tomography computed tomography scans before radical RT (Day 0) and at Days 7 and 14 of RT. On all scans, the high and low FDG uptake regions were autodelineated using several standardized uptake value thresholds, varying from 34% to 80% of the maximal standardized uptake value. The volumes and overlap fractions of these delineations were calculated to demonstrate the stability of the high FDG uptake regions during RT.
The mean overlap fraction of the 34% uptake zones at Day 0 with Days 7 and 14 was 82.8% +/- 8.1% and 84.3% +/- 7.6%, respectively. The mean overlap fraction of the high uptake zones (60%) was 72.3% +/- 15.0% and 71.3% +/- 19.7% at Day 0 with Days 7 and 14, respectively. The volumes of the thresholds varied markedly (e.g., at Day 0, the volume of the 60% zone was 16.8 +/- 20.3 cm(3)). In contrast, although the location of the high FDG uptake patterns within the tumor during RT remained stable, the delineated volumes varied markedly.
The location of the low and high FDG uptake areas within the tumor remained stable during RT. This knowledge may enable selective boosting of high FDG uptake areas within the tumor.
由于个体肿瘤具有异质性，包括对（18）F - 脱氧葡萄糖（FDG）的摄取，并且很可能在放射抗性方面也存在异质性，因此有人提出对肿瘤内高FDG摄取区域进行选择性增强照射。要做到这一点，关键是要了解这些肿瘤内高FDG摄取模式的位置在放射治疗（RT）期间是否保持稳定。
23例I - III期非小细胞肺癌患者在根治性放疗前（第0天）以及放疗第7天和第14天接受了重复的FDG正电子发射断层扫描计算机断层扫描。在所有扫描中，使用几个标准化摄取值阈值（从最大标准化摄取值 的34%到80%不等）自动勾勒出高和低FDG摄取区域。计算这些勾勒区域 的体积和重叠分数，以证明放疗期间高FDG摄取区域的稳定性。
第0天34%摄取区域与第7天和第14天的平均重叠分数分别为82.8%±8.1%和84.3%±7.6%。第0天高摄取区域（60%）与第7天和第14天的平均重叠分数分别为72.3%±15.0%和71.3%±19.7%。阈值的体积变化显著（例如，在第0天，60%区域的体积为16.8±20.3 cm³）。相比之下，尽管放疗期间肿瘤内高FDG摄取模式的位置保持稳定，但勾勒出的体积变化显著。
放疗期间肿瘤内低和高FDG摄取区域的位置保持稳定。这一认识可能有助于对肿瘤内高FDG摄取区域进行选择性增强照射。
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