MacManus Michael, Nestle Ursula, Rosenzweig Kenneth E, Carrio Ignasi, Messa Cristina, Belohlavek Otakar, Danna Massimo, Inoue Tomio, Deniaud-Alexandre Elizabeth, Schipani Stefano, Watanabe Naoyuki, Dondi Maurizio, Jeremic Branislav
Department of Radiation Oncology, Peter MacCallum Cancer Centre, Australia.
Radiother Oncol. 2009 Apr;91(1):85-94. doi: 10.1016/j.radonc.2008.11.008. Epub 2008 Dec 25.
Positron Emission Tomography (PET) is a significant advance in cancer imaging with great potential for optimizing radiation therapy (RT) treatment planning and thereby improving outcomes for patients. The use of PET and PET/CT in RT planning was reviewed by an international panel. The International Atomic Energy Agency (IAEA) organized two synchronized and overlapping consultants' meetings with experts from different regions of the world in Vienna in July 2006. Nine experts and three IAEA staff evaluated the available data on the use of PET in RT planning, and considered practical methods for integrating it into routine practice. For RT planning, (18)F fluorodeoxyglucose (FDG) was the most valuable pharmaceutical. Numerous studies supported the routine use of FDG-PET for RT target volume determination in non-small cell lung cancer (NSCLC). There was also evidence for utility of PET in head and neck cancers, lymphoma and in esophageal cancers, with promising preliminary data in many other cancers. The best available approach employs integrated PET/CT images, acquired on a dual scanner in the radiotherapy treatment position after administration of tracer according to a standardized protocol, with careful optimization of images within the RT planning system and carefully considered rules for contouring tumor volumes. PET scans that are not recent or were acquired without proper patient positioning should be repeated for RT planning. PET will play an increasing valuable role in RT planning for a wide range of cancers. When requesting PET scans, physicians should be aware of their potential role in RT planning.
正电子发射断层扫描（PET）是癌症成像领域的一项重大进展，在优化放射治疗（RT）治疗计划从而改善患者治疗效果方面具有巨大潜力。一个国际专家小组对PET和PET/CT在放射治疗计划中的应用进行了综述。国际原子能机构（IAEA）于2006年7月在维也纳组织了两次同步且重叠的顾问会议，与会专家来自世界不同地区。九位专家和三名IAEA工作人员评估了PET在放射治疗计划中应用的现有数据，并考虑了将其纳入常规实践的实用方法。对于放射治疗计划而言，（18）F氟脱氧葡萄糖（FDG）是最具价值的药物。众多研究支持在非小细胞肺癌（NSCLC）的放射治疗靶区确定中常规使用FDG-PET。也有证据表明PET在头颈癌、淋巴瘤和食管癌中具有应用价值，在许多其他癌症中也有很有前景的初步数据。最佳可用方法是使用集成的PET/CT图像，在注射示踪剂后，按照标准化方案在放射治疗位置的双扫描仪上采集，在放射治疗计划系统内仔细优化图像，并仔细考虑勾画肿瘤体积的规则。对于放射治疗计划，若PET扫描不是近期的或在患者未正确定位的情况下采集的，应重新进行扫描。PET在广泛癌症的放射治疗计划中将发挥越来越重要的作用。在要求进行PET扫描时，医生应了解其在放射治疗计划中的潜在作用。
