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一项比较非转移性非小细胞肺癌 CT 放疗计划与 PET-CT 放疗计划剂量学的前瞻性研究。

A Prospective Study Comparing Dosimetry between Computed Tomography (CT) based Radiation Planning and Positron Emission Computed Tomography (PET-CT) based Radiation Planning in Treatment of Non-Metastatic Non Small Cell Lung Carcinoma.

机构信息

Department Of Radiotherapy, Medical College & Hospital Kolkata, Room no 13, 88 College Street, Kolkata 700073, West Bengal, India.

出版信息

Asian Pac J Cancer Prev. 2023 Jul 1;24(7):2543-2550. doi: 10.31557/APJCP.2023.24.7.2543.

DOI:10.31557/APJCP.2023.24.7.2543
PMID:37505789
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10676499/
Abstract

BACKGROUND

To evaluate dosimetry between CT based radiation planning and PET-CT based radiation planning.

MATERIAL & METHODS: Histologically proven 40 cases of locally advanced non-small cell carcinoma of lung were accrued for the prospective study. Contrast enhanced planning CT images and PET images were acquired. Target volume delineation, organs of interest & radiation planning were performed in Eclipse V 14.5 followed by dosimetric comparison among GTV, PTV and OARs. A p-value of <0.05 was considered significant.

RESULTS

The mean of GTV were 141.18 ± 119.76 cc in CT and 115.54 ± 91.02 cc in PET-CT based and the difference was statistically significant (p=0.03). The mean of CTV were 313.91 ± 180.87 cc in CT and 260.81 ± 148.83 cc in PET-CT based and the difference was statistically significant (p=0.03). The contralateral lung mean dose was statistically very significant (p<0.01) among both the 3D-CRT plans which were 8.49 Gy in CECT based planning and 9.53 Gy in PET CT based planning. The heart mean dose was also statistically significant (p=0.03) among the plans which were 17.90 Gy in CECT based planning and 17.06 Gy in PET CT based planning. Mann-Whitney U test showed the CT based PTV D90 was 58.20 Gy vs 57.58 Gy in PET CT based planning (p=0.02). PTV V95 were also comparable in both of the plans (p=0.02).

CONCLUSIONS

GTV measured using PET-CT, may be greater or lesser than the CECT-based GTV. PET-CT-based contouring is more accurate for identifying tumour margins and new lymph node volumes.

摘要

背景

评估 CT 基础放射计划与 PET-CT 基础放射计划之间的剂量学差异。

材料与方法

前瞻性研究纳入 40 例经组织学证实的局部晚期非小细胞肺癌患者。采集增强对比 CT 图像和 PET 图像。在 Eclipse V 14.5 中进行靶区勾画、感兴趣器官勾画和放射计划，并对 GTV、PTV 和 OAR 进行剂量比较。p 值<0.05 被认为具有统计学意义。

结果

CT 上的 GTV 平均值为 141.18±119.76 cc，而 PET-CT 上的 GTV 平均值为 115.54±91.02 cc，差异具有统计学意义（p=0.03）。CT 上的 CTV 平均值为 313.91±180.87 cc，而 PET-CT 上的 CTV 平均值为 260.81±148.83 cc，差异具有统计学意义（p=0.03）。3D-CRT 计划中，对侧肺的平均剂量差异具有统计学意义（p<0.01），CECT 基础计划中的平均剂量为 8.49 Gy，而 PET CT 基础计划中的平均剂量为 9.53 Gy。心脏的平均剂量也具有统计学意义（p=0.03），CECT 基础计划中的平均剂量为 17.90 Gy，而 PET CT 基础计划中的平均剂量为 17.06 Gy。Mann-Whitney U 检验显示 CT 基础 PTV D90 为 58.20 Gy，而 PET CT 基础计划中的 PTV D90 为 57.58 Gy（p=0.02）。两种计划中的 PTV V95 也具有可比性（p=0.02）。

结论

使用 PET-CT 测量的 GTV 可能大于或小于 CECT 基础 GTV。PET-CT 基础勾画对于识别肿瘤边界和新的淋巴结体积更准确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/27f4fd297134/APJCP-24-2543-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/968eac26e2ed/APJCP-24-2543-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/8f3f9b6392f0/APJCP-24-2543-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/edfcda3844b2/APJCP-24-2543-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/27f4fd297134/APJCP-24-2543-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/968eac26e2ed/APJCP-24-2543-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/8f3f9b6392f0/APJCP-24-2543-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/edfcda3844b2/APJCP-24-2543-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edb/10676499/27f4fd297134/APJCP-24-2543-g004.jpg

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