Lin Shan, Han Bo, Yu Lijuan, Shan Dan, Wang Ruizhi, Ning Xiaoming
Department of Oncology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Nucl Med Commun. 2011 Jun;32(6):479-85. doi: 10.1097/MNM.0b013e32834508d2.
This study was designed to investigate the feasibility of a method derived from fused positron emission tomography-computed tomography (PET-CT) images for the delineation of gross tumor volume (GTV) in nonsmall cell lung cancer (NSCLC) and to explore the correlation between PET-CT and histopathological findings.
Thirty-seven patients were enrolled in this study; all patients were evaluated by PET-CT and underwent surgery within 1 week after the scan. The radiation oncologist, together with the radiologist, first delineated the GTV-based CT and then with an experienced nuclear medicine physician contoured the same GTV using the distinctive visual 'halo' in fused PET-CT images. The characteristics of the halo phenomenon were analyzed, including the standardized uptake value (SUV). The excised surgical specimens were labeled and the maximum diameter of the tumor in the right-left axis of the tissue blocks was measured on consecutive histopathology slides; the histopathological slice images were scanned using a digital pathology scanner after staining with hematoxylin and eosin.
The mean SUV of the external margins of the halos was 2.41±0.73 (range 1.4-4.1); the histopathological type and T-stage significantly influenced the SUV of the external margin of the halos (P=0.004 and 0.027). The correlation coefficients of maximum diameter in the right-left axis and in the anterior-posterior axis between fused PET-CT images and histopathology were 0.935 and 0.943, respectively; the values between CT imaging and histopathological examination were 0.82 and 0.763.
There is a correlation between GTV based on the'halo' of fused PET-CT images and the excised surgical specimen of primary tumor.It may be feasible to use the 'halo' characteristics in fused PET-CT images to delineate GTV in NSCLCs, but its reliability should be further investigated to establish an accurate spatial imaging-pathology correlation for primary tumors delineation in NSCLCs.
本研究旨在探讨一种源自融合正电子发射断层扫描-计算机断层扫描（PET-CT）图像的方法在非小细胞肺癌（NSCLC）中勾画大体肿瘤体积（GTV）的可行性，并探索PET-CT与组织病理学结果之间的相关性。
37例患者纳入本研究；所有患者均接受PET-CT评估，并在扫描后1周内接受手术。放射肿瘤学家与放射科医生首先基于CT勾画GTV，然后由经验丰富的核医学医生利用融合PET-CT图像中独特的视觉“晕圈”勾勒相同的GTV。分析晕圈现象的特征，包括标准化摄取值（SUV）。对切除的手术标本进行标记，并在连续的组织病理学切片上测量组织块肿瘤在左右轴上的最大直径；苏木精和伊红染色后，使用数字病理扫描仪扫描组织病理学切片图像。
晕圈外缘的平均SUV为2.41±0.73（范围1.4 - 4.1）；组织病理学类型和T分期对晕圈外缘的SUV有显著影响（P = 0.004和0.027）。融合PET-CT图像与组织病理学在左右轴和前后轴上最大直径的相关系数分别为0.935和0.943；CT成像与组织病理学检查之间的值分别为0.82和0.763。
基于融合PET-CT图像“晕圈”的GTV与原发性肿瘤切除的手术标本之间存在相关性。利用融合PET-CT图像中的“晕圈”特征勾画NSCLC中的GTV可能是可行的，但其可靠性应进一步研究，以建立NSCLC中准确的原发性肿瘤空间成像-病理学相关性用于肿瘤勾画。
