Créhange G, Soussan M, Gensanne D, Decazes P, Thariat J, Thureau S
Département de radiothérapie oncologique, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
Service de médecine nucléaire, hôpital Avicenne, AP-HP, hôpitaux universitaires, 125, rue de Stalingrad, 93000 Bobigny, France.
Cancer Radiother. 2020 Aug;24(5):398-402. doi: 10.1016/j.canrad.2020.02.010. Epub 2020 Apr 1.
Computed tomography (CT) in the treatment position is currently indispensable for planning radiation therapy. Other imaging modalities, such as magnetic resonance imaging (MRI) and positron emission-tomography (PET), can be used to improve the definition of the tumour and/or healthy tissue but also to provide functional data of the target volume. Accurate image registration is essential for treatment planning, so MRI and PET scans should be registered at the planning CT scan. Hybrid PET/MRI scans with a hard plane can be used but pose the problem of the absence of CT scans. Finally, techniques for moving the patient on a rigid air-cushioned table allow PET/CT/MRI scans to be performed in the treatment position while limiting the patient's movements exist. At the same time, the advent of MRI-linear accelerator systems allows to redefine image-guided radiotherapy and to propose treatments with daily recalculation of the dose. The place of PET during treatment remains more confidential and currently only in research and prototype status. The same development of imaging during radiotherapy is underway in proton therapy.
在治疗位置进行计算机断层扫描（CT）目前对于放射治疗计划而言必不可少。其他成像模态，如磁共振成像（MRI）和正电子发射断层扫描（PET），可用于改善肿瘤和/或健康组织的清晰度，还能提供靶区的功能数据。精确的图像配准对于治疗计划至关重要，因此MRI和PET扫描应与计划CT扫描进行配准。具有硬平面的混合PET/MRI扫描可以使用，但存在缺少CT扫描的问题。最后，在刚性气垫床上移动患者的技术使得PET/CT/MRI扫描能够在治疗位置进行，同时限制患者的移动。与此同时，MRI直线加速器系统的出现使得能够重新定义图像引导放射治疗，并提出每日重新计算剂量的治疗方案。PET在治疗期间的应用仍较为保密，目前仅处于研究和原型阶段。质子治疗中放射治疗期间的成像也在进行同样的发展。
