Department of Radiation Oncology, Stanford University School of Medicine, United States.
Radiother Oncol. 2011 Dec;101(3):356-61. doi: 10.1016/j.radonc.2011.05.040. Epub 2011 Jun 12.
To explore the relationship between pathologic tumor volume and volume estimated from different tumor segmentation techniques on (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in oral cavity cancer.
Twenty-three patients with squamous cell carcinoma of the oral tongue had PET-CT scans before definitive surgery. Pathologic tumor volume was estimated from surgical specimens. Metabolic tumor volume (MTV) was defined from PET-CT scans as the volume of tumor above a given SUV threshold. Multiple SUV thresholds were explored including absolute SUV thresholds, relative SUV thresholds, and gradient-based techniques.
Multiple MTV's were associated with pathologic tumor volume; however the correlation was poor (R(2) range 0.29-0.58). The ideal SUV threshold, defined as the SUV that generates an MTV equal to pathologic tumor volume, was independently associated with maximum SUV (p=0.0005) and tumor grade (p=0.024). MTV defined as a function of maximum SUV and tumor grade improved the prediction of pathologic tumor volume (R(2)=0.63).
Common SUV thresholds fail to predict pathologic tumor volume in head and neck cancer. The optimal technique that allows for integration of PET-CT with radiation treatment planning remains to be defined. Future investigation should incorporate biomarkers such as tumor grade into definitions of MTV.
探讨口腔癌（18）F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）中不同肿瘤分割技术估计的肿瘤体积与病理肿瘤体积之间的关系。
23 例舌鳞状细胞癌患者在根治性手术前进行了 PET-CT 扫描。病理肿瘤体积由手术标本估计。代谢肿瘤体积（MTV）定义为 PET-CT 扫描中肿瘤体积超过给定 SUV 阈值的体积。探索了多个 SUV 阈值，包括绝对 SUV 阈值、相对 SUV 阈值和基于梯度的技术。
多个 MTV 与病理肿瘤体积相关，但相关性较差（R²范围 0.29-0.58）。定义为生成与病理肿瘤体积相等的 MTV 的理想 SUV 阈值与最大 SUV（p=0.0005）和肿瘤分级（p=0.024）独立相关。作为最大 SUV 和肿瘤分级函数的 MTV 提高了病理肿瘤体积的预测（R²=0.63）。
常见的 SUV 阈值不能预测头颈部癌症的病理肿瘤体积。允许将 PET-CT 与放射治疗计划相结合的最佳技术仍有待确定。未来的研究应将肿瘤分级等生物标志物纳入 MTV 的定义中。
