Lucien Neuwirth Cancer Centre, Department of Radiation, Saint-Étienne, France.
Lyon Sud Hospital, Nuclear Medicine Department, Lyon, France.
Bull Cancer. 2022 Dec;109(12):1262-1268. doi: 10.1016/j.bulcan.2022.07.008. Epub 2022 Oct 22.
The necessity to perform FDG PET-CT both for initial tumour staging and for target volume delineation in head and neck cancers seems well established. The aim of the present study is to advocate the place and role of FDG PET-CT acquired in planning treatment position (FDG PET-CT/RT).
Between March 2018 and July 2019, 22 patients with a squamous cell head and neck carcinoma treated by EBRT were included in the analysis. All these consecutive patients had a FDG PET-CT/RT. Three GTV volumes were defined. First, "GTV 40%" corresponded to 40% of SUV. "Visual GTV" was defined as the tumor volume obtained from the PET the nuclear medicine physician interpreted. The radiation oncologist used the medical record, clinical anatomy, CT simulation and FDG PET-CT/RT data ("GTV40%" and "visual GTV") to draw the GTV.
Mean GTVs and mean "GTVs40%" were significantly different (P<0.001) with an intraclass index of 0.734. Mean "GTV40%" and mean "visual GTVs" were also significantly different (P<0.001) with an intraclass index of 0.72. Conversely, the difference between mean GTVs and mean "visual GTVs" were not significant (P=0.11) with an intraclass index of 0.91. Mean DICE between "GTVs40%" and GTV was 0.7 (ranging from 0.2 to 0.9). The mean intersection between GTVs and "visual GTVs" volumes was 0.8 (ranging from 0.4 to 1). The difference between DICES was significant (P=0.015), "visual GTV"/GTV DICE was the smallest.
FDG PET-CT/RT definitely remains the imaging modality that individualized/customized head and neck cancer treatment needs.
对头颈部癌症进行初始肿瘤分期和靶区勾画都需要进行 FDG PET-CT 检查，这一点似乎已经得到了充分证实。本研究的目的是提倡在治疗计划位置（FDG PET-CT/RT）采集 FDG PET-CT 的作用和地位。
2018 年 3 月至 2019 年 7 月，共纳入 22 例接受 EBRT 治疗的头颈部鳞状细胞癌患者。所有患者均行 FDG PET-CT/RT 检查。共定义了 3 个 GTV 体积。首先，“GTV40%”对应于 SUV 的 40%。“视觉 GTV”是指核医学医师解释的 PET 肿瘤体积。放射肿瘤医师使用病历、临床解剖学、CT 模拟和 FDG PET-CT/RT 数据（“GTV40%”和“视觉 GTV”）来勾画 GTV。
平均 GTV 和平均“GTV40%”差异有统计学意义（P<0.001），组内相关系数为 0.734。平均“GTV40%”和平均“视觉 GTV”差异也有统计学意义（P<0.001），组内相关系数为 0.72。相反，平均 GTV 和平均“视觉 GTV”之间的差异无统计学意义（P=0.11），组内相关系数为 0.91。“GTV40%”和 GTV 之间的平均 DICE 为 0.7（范围为 0.2 至 0.9）。GTV 和“视觉 GTV”之间的平均交集为 0.8（范围为 0.4 至 1）。DICE 之间的差异有统计学意义（P=0.015），“视觉 GTV”/GTV 的 DICE 最小。
FDG PET-CT/RT 无疑仍然是个体化/定制头颈部癌症治疗需求的成像方式。
