Multimodality nuclear medicine imaging in three-dimensional radiation treatment planning for lung cancer: challenges and prospects
Multimodality nuclear medicine imaging in three-dimensional radiation treatment planning for lung cancer: challenges and prospects
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DOI：
10.1016/s0169-5002(99)00005-7
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发表时间：
1999-02-01
期刊：
影响因子：
5.3
通讯作者：
Coleman, RE
中科院分区：
文献类型：
--
作者：
Munley, MT;Marks, LB;Coleman, RE
本研究的目的是确定定量单光子发射计算机断层扫描（SPECT）肺灌注扫描和F-18氟脱氧葡萄糖正电子发射计算机断层扫描（PET）在肺癌患者基于X射线计算机断层扫描（CT）的治疗计划中的效用。临床医生可获得放射治疗前SPECT（n = 104）和PET（n = 35）图像，以协助支气管肺癌患者的辐射野设计。SPECT和PET扫描与来自CT的解剖信息配准。来自SPECT和PET的信息为治疗计划者提供了用CT看不到的功能数据。SPECT产生三维（3D）肺灌注图。PET提供有助于肿瘤定位的3D代谢图像。通过确定计划变更的频率、类型和程度，评估核医学图像对治疗计划过程的影响。放疗前SPECT扫描用于修改11（11%）个治疗计划;主要是改变射束角度以避免高功能组织。50个（48%）SPECT数据集被判定为“潜在有用”，因为：检测肺灌注不足区域，但在治疗计划期间未使用。PET数据影响了34%（12/35）的治疗计划检查，并导致扩大部分射束孔径（利润）高达15 mm。在治疗计划过程中利用核医学数据时，出现与图像质量和配准相关的挑战。临床上通常不使用的高级SPECT图像重建技术的初始实现表明，重建方法可能会影响从SPECT图像导出的剂量响应数据，并改善与CT的图像配准。使用核医学透射计算机断层扫描（TCT）的SPECT和PET作为一种可能的工具，以重建更准确的发射图像，并协助在发射数据与规划CT的配准。核医学成像技术似乎是一个潜在的有价值的工具，在肺癌患者的放射治疗计划。利用精确的核医学图像重建技术和TCT可以改善治疗计划过程。(C)1999爱思唯尔科学爱尔兰有限公司保留所有权利。
The purpose of this study was to determine the utility of quantitative single photon emission computed tomography (SPECT) lung perfusion scans and F-18 fluorodeoxyglucose positron emission computed tomography (PET) during X-ray computed tomography (CT)-based treatment planning for patients with lung cancer. Pre-radiotherapy SPECT (n = 104) and PET (n = 35) images were available to the clinician to assist in radiation field design for patients with bronchogenic cancer. The SPECT and PET scans were registered with anatomic information derived from CT. The information from SPECT and PET provides the treatment planner with functional data not seen with CT. SPECT yields three-dimensional (3D) lung perfusion maps. PET provides 3D metabolic images that assist in tumor localization. The impact of the nuclear medicine images on the treatment planning process was assessed by determining the frequency, type, and extent of changes to plans. Pre-radiotherapy SPECT scans were used to modify 11 (11%) treatment plans; primarily altering beam angles to avoid highly functioning tissue. Fifty (48%) SPECT datasets were judged to be 'potentially useful' due to the: detection of hypoperfused regions of the lungs, but were not used during treatment planning. PET data influenced 34% (12 of 35) of the treatment plans examined, and resulted in enlarging portions of the beam aperture (margins) up to 15 mm. Challenges associated with image quality and registration arise when utilizing nuclear medicine data in the treatment planning process. Initial implementation of advanced SPECT image reconstruction techniques that are not typically used in the clinic suggests that the reconstruction method may influence dose response data derived from the SPECT images and improve image registration with CT. The use of nuclear medicine transmission computed tomography (TCT) for both SPECT and PET is presented as a possible tool to reconstruct more accurate emission images and to aid in the registration of emission data with the planning CT. Nuclear medicine imaging techniques appear to be a potentially valuable tool during radiotherapy treatment planning for patients with lung cancer. The utilization of accurate nuclear medicine image reconstruction techniques and TCT may improve the treatment planning process. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.