Marta Gustavo Nader, Hanna Samir Abdallah, Sa de Camargo Etchebehere Elba Cristina, Camargo Edwaldo Eduardo, Haddad Cecília Maria Kalil, Fernandes da Silva João Luis
Department of Radiotherapy, Hospital Sírio-Libanês, Sao Paulo, Brazil.
Nucl Med Commun. 2011 Oct;32(10):903-7. doi: 10.1097/MNM.0b013e32834a719a.
This study aimed to compare the clinical target volumes (CTV) delineated by computed tomography (CT) and positron emission tomography (PET)/CT using fluoro-deoxy-glucose to assess the impact of using PET information for radiotherapy (RT) planning.
We retrospectively reviewed data on patients with tumors from different sites who had indications for RT and had undergone RT treatment planning with PET/CT at our institution between July 2003 and July 2009. Statistical analysis included the comparison of CTV planned for treatment only by CT (CTV(CT)) with that by PET/CT (CTV(PET)) using the Wilcoxon test for paired samples.
Of 105 patients eligible for analysis, 56.2% were men. The most common diagnoses were head and neck cancer (28.6%), lung cancer (21.9%), lymphoma (11.4%), upper gastrointestinal (10.5%), and others (14.3%). Comparison of CTV(CT) and CTV(PET) revealed that RT planning has changed in 77% of cases because of PET/CT additional information, with impact on treatment volume varying according to diagnosis. Despite the absolute difference observed between median CTVs, there was no significant difference between CTV(CT) and CTV(PET) (114 vs. 90.4 ml, respectively; P=0.1266), considering all patients. Nonetheless, a significant difference between CTVs delineated by CT and PET/CT was found when only head and neck, lung and lymphoma cases--representing more than 60% of the sample--were examined (112.5 and 80.7 ml, respectively; P=0.0053).
We have shown that PET/CT use promotes significant changes in the CTV delineated for treatment of different tumors, modifying RT planning. Our data suggest that PET/CT has a good potential for optimizing RT treatment planning, especially in head and neck, lung, and lymphoma tumors.
本研究旨在比较通过计算机断层扫描（CT）和使用氟脱氧葡萄糖的正电子发射断层扫描（PET）/CT所勾画的临床靶区（CTV），以评估使用PET信息进行放射治疗（RT）计划的影响。
我们回顾性分析了2003年7月至2009年7月期间在我院接受RT治疗计划且进行了PET/CT检查的不同部位肿瘤患者的数据。统计分析包括使用配对样本的Wilcoxon检验比较仅通过CT计划的CTV（CTV(CT)）和通过PET/CT计划的CTV（CTV(PET)）。
在105例符合分析条件的患者中，56.2%为男性。最常见的诊断为头颈癌（28.6%）、肺癌（21.9%）、淋巴瘤（11.4%）、上消化道肿瘤（10.5%）及其他（14.3%）。CTV(CT)与CTV(PET)的比较显示，77%的病例因PET/CT的额外信息使RT计划发生了改变，对治疗体积的影响因诊断而异。尽管观察到的CTV中位数存在绝对差异，但考虑所有患者时，CTV(CT)与CTV(PET)之间无显著差异（分别为114 ml和90.4 ml；P = 0.1266）。然而，仅对头颈、肺部和淋巴瘤病例（占样本的60%以上）进行检查时，发现CT和PET/CT所勾画的CTV之间存在显著差异（分别为112.5 ml和80.7 ml；P = 0.0053）。
我们已经表明，使用PET/CT会促使为不同肿瘤治疗所勾画的CTV发生显著变化，从而改变RT计划。我们的数据表明，PET/CT在优化RT治疗计划方面具有很大潜力，尤其是在头颈、肺部和淋巴瘤肿瘤中。
