MAASTRO Clinic, Radiation Oncology, Maastricht, The Netherlands.
Strahlenther Onkol. 2010 Sep;186(9):471-81. doi: 10.1007/s00066-010-2150-1. Epub 2010 Aug 30.
Fluorodeoxyglucose positron emission tomography (FDG-PET) plays an increasingly important role in radiotherapy, beyond staging and selection of patients. Especially for non-small cell lung cancer, FDG-PET has, in the majority of the patients, led to the safe decrease of radiotherapy volumes, enabling radiation dose escalation and, experimentally, redistribution of radiation doses within the tumor. In limited-disease small cell lung cancer, the role of FDG-PET is emerging. For primary brain tumors, PET based on amino acid tracers is currently the best choice, including high-grade glioma. This is especially true for low-grade gliomas, where most data are available for the use of (11)C-MET (methionine) in radiation treatment planning. For esophageal cancer, the main advantage of FDG-PET is the detection of otherwise unrecognized lymph node metastases. In Hodgkin's disease, FDG-PET is essential for involved-node irradiation and leads to decreased irradiation volumes while also decreasing geographic miss. FDG-PET's major role in the treatment of cervical cancer with radiation lies in the detection of para-aortic nodes that can be encompassed in radiation fields. Besides for staging purposes, FDG-PET is not recommended for routine radiotherapy delineation purposes. It should be emphasized that using PET is only safe when adhering to strictly standardized protocols.
氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）在放射治疗中的作用日益重要，不仅用于分期和选择患者。特别是对于非小细胞肺癌，FDG-PET 在大多数患者中导致了放疗体积的安全减少，使辐射剂量升级成为可能，并在实验中实现了肿瘤内辐射剂量的重新分配。在局限期小细胞肺癌中，FDG-PET 的作用正在显现。对于原发性脑肿瘤，基于氨基酸示踪剂的 PET 目前是最佳选择，包括高级别胶质瘤。对于低级别胶质瘤尤其如此，其中大多数数据可用于（11）C-MET（蛋氨酸）在放射治疗计划中的应用。对于食管癌，FDG-PET 的主要优势在于检测到否则无法识别的淋巴结转移。在霍奇金病中，FDG-PET 对于受累淋巴结照射至关重要，可减少照射体积，同时减少地理遗漏。FDG-PET 在宫颈癌放射治疗中的主要作用在于检测可以包含在放射野中的腹主动脉旁淋巴结。除了分期目的外，不建议将 FDG-PET 常规用于放射治疗勾画。应强调的是，只有严格遵循标准化方案，使用 PET 才是安全的。
