Image fusion between 18FDG-PET and MRI/CT for radiotherapy planning of oropharyngeal and nasopharyngeal carcinomas
Image fusion between 18FDG-PET and MRI/CT for radiotherapy planning of oropharyngeal and nasopharyngeal carcinomas
复制标题
DOI：
10.1016/s0360-3016(02)02854-7
复制
发表时间：
2002-07-15
影响因子：
7
通讯作者：
Miyasaka, K
中科院分区：
文献类型：
--
作者：
Nishioka, T;Shiga, T;Miyasaka, K
目的：在三维适形放射治疗中，准确诊断肿瘤范围是非常重要的。本研究报告了（18）F-氟-2-脱氧-D-葡萄糖正电子发射断层扫描（（18）FDG-PET）和磁共振成像/计算机断层扫描（MRI/CT）之间的图像融合在头颈部癌症的放射治疗计划中用于更好的靶勾画。研究对象包括12例口咽癌和9例鼻咽癌在1999年7月至2001年2月期间接受根治性放射治疗的患者。使用自动多模态图像配准算法进行（18）FDG-PET和MRI/CT之间的图像融合，该算法使用大脑作为配准的内部参考。根据临床检查和（18）融合图像上的FDG摄取确定肿瘤总体积（GTV）。结果：除3例浅表肿瘤外，其余18例原发肿瘤均被FDG-PET检出。19例（89%）原发肿瘤的GTV体积在图像融合后没有改变，1例NPC增加了49%，另1例NPC减少了45%。基于融合图像上更清晰的GTV和CTV确定，更容易进行正常组织保留。特别是，腮腺保留成为可能的15例（71%），其上颈部区域附近的腮腺是无肿瘤的（18）FDG-PET。在平均随访18个月内，没有复发发生在定义为CTV，这是治疗的区域，除了1例谁经历了淋巴结复发的CTV和同时原发部位recursion.Conclusion：这个初步研究表明，（18）FDG-PET和MRI/CT之间的图像融合是有用的GTV和CTV确定适形RT，从而节省正常组织。(C)2002年爱思唯尔科学公司
Purpose: Accurate diagnosis of tumor extent is important in three-dimensional conformal radiotherapy. This study reports the use of image fusion between (18)F-fluoro-2-deoxy-D-glucose positron emission tomography ((18)FDG-PET) and magnetic resonance imaging/computed tomography (MRI/CT) for better targets delineation in radiotherapy planning of head-and-neck cancers.Methods and Materials: The subjects consisted of 12 patients with oropharyngeal carcinoma and 9 patients with nasopharyngeal carcinoma (NPC) who were treated with radical radiotherapy between July 1999 and February 2001. Image fusion between (18)FDG-PET and MRI/CT was performed using an automatic multimodality image registration algorithm, which used the brain as an internal reference for registration. Gross tumor volume (GTV) was determined based on clinical examination and (18)FDG uptake on the fusion images. Clinical target volume (CTV) was determined following the usual pattern of lymph node spread for each disease entity along with the clinical presentation of each patient.Results: Except for 3 cases with superficial tumors, all the other primary tumors were detected by (18)FDG-PET. The GTV volumes for primary tumors were not changed by image fusion in 19 cases (89%), increased by 49% in one NPC, and decreased by 45% in another NPC. Normal tissue sparing was more easily performed based on clearer GTV and CTV determination on the fusion images. In particular, parotid sparing became possible in 15 patients (71%) whose upper neck areas near the parotid glands were tumor-free by (18)FDG-PET. Within a mean follow-up period of 18 months, no recurrence occurred in the areas defined as CTV, which was treated prophylactically, except for 1 patient who experienced nodal recurrence in the CTV and simultaneous primary site recurrence.Conclusion: This preliminary study showed that image fusion between (18)FDG-PET and MRI/CT was useful in GTV and CTV determination in conformal RT, thus sparing normal tissues. (C) 2002 Elsevier Science Inc.