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首页> 外文学位 >The prognostic value of functional and anatomical parameters for the selection of patients receiving yttrium-90 microspheres for the treatment of liver cancer.
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The prognostic value of functional and anatomical parameters for the selection of patients receiving yttrium-90 microspheres for the treatment of liver cancer.

机译：功能和解剖学参数对选择接受钇90微球治疗肝癌患者的预后价值。

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摘要

Yttrium-90 (90Y) microsphere therapy is being utilized as a treatment option for patients with primary and metastatic liver cancer due to its ability to target tumors within the liver. The success of this treatment is dependent on many factors, including the extent and type of disease and the nature of prior treatments received. Metabolic activity, as determined by PET imaging, may correlate with the number of viable cancer cells and reflect changes in viable cancer cell volume. However, contouring of PET images by hand is labor intensive and introduces an element of irreproducibility into the determination of functional target/tumor volume (FTV). A computer-assisted method to aid in the automatic contouring of FTV has the potential to substantially improve treatment individualization and outcome assessment.;Commercial software to determine FTV in FDG-avid primary and metastatic liver tumors has been evaluated and optimized. Volumes determined using the automated technique were compared to those from manually drawn contours identified using the same cutoff in the standard uptake value (SUV). The reproducibility of FTV is improved through the introduction of an optimal threshold value determined from phantom experiments. Application of the optimal threshold value from the phantom experiments to patient scans was in good agreement with hand-drawn determinations of the FTV. It is concluded that computer-assisted contouring of the FTV for primary and metastatic liver tumors improves reproducibility and increases accuracy, especially when combined with the selection of an optimal SUV threshold determined from phantom experiments.;A method to link the pre-treatment assessment of functional (PET based) and anatomical (CT based) parameters to post-treatment survival and time to progression was evaluated in 22 patients with colorectal cancer liver metastases treated using 90Y microspheres and chemotherapy. The values for pre-treatment parameters that were the best predictors of response were determined for FTV, anatomical tumor volume, total lesion glycolysis, and the tumor marker, CEA. Of the parameters considered, the best predictors of response were found to be pre-treatment FTV ≤153 cm3, ATV ≤163 cm3, TLG ≤144 g in the chemo-SIRT treated field, and CEA ≤11.6 ng/mL.
机译：Yttrium-90（90Y）微球疗法由于具有靶向肝内肿瘤的能力，因此已被用作患有原发性和转移性肝癌患者的治疗选择。该治疗的成功取决于许多因素，包括疾病的程度和类型以及所接受的先前治疗的性质。通过PET成像确定的代谢活性可能与存活癌细胞的数量相关，并反映了存活癌细胞体积的变化。然而，用手对PET图像进行轮廓绘制是费力的，并且将不可再现性的要素引入功能靶标/肿瘤体积（FTV）的确定中。一种辅助FTV自动轮廓化的计算机辅助方法有可能显着改善治疗个体化和疗效评估。;已经评估和优化了用于确定FDG-avid原发性和转移性肝肿瘤中FTV的商业软件。将使用自动技术确定的体积与使用标准摄取值（SUV）的相同截断线确定的手动绘制轮廓中的体积进行比较。通过引入从幻像实验确定的最佳阈值，可以提高FTV的可重复性。将幻影实验中的最佳阈值应用于患者扫描，与FTV的手工确定结果非常吻合。结论是，计算机辅助的FTV轮廓治疗原发性和转移性肝肿瘤可提高重现性并提高准确性，特别是与选择从幻像实验确定的最佳SUV阈值相结合时。对使用90Y微球和化学疗法治疗的22例结直肠癌肝转移患者的治疗后生存率和进展时间进行了功能性（基于PET的）和解剖学（基于CT的）参数的评估。确定FTV，解剖学肿瘤体积，总病变糖酵解和肿瘤标志物CEA的最佳预测指标，即治疗前参数的值。在所考虑的参数中，发现响应的最佳预测因子是在化学SIRT处理的领域中，治疗前FTV≤153cm3，ATV≤163cm3，TLG≤144g和CEA≤11.6ng / mL。

著录项

  • 作者

    Mesoloras, Geraldine.;

  • 作者单位

    Purdue University.;

  • 授予单位 Purdue University.;
  • 学科 Health Sciences Radiology.;Health Sciences Oncology.;Physics Radiation.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 102 p.
  • 总页数 102
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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