Objective To discuss the influence of the therapeutic schedule of economic PET/CT for non - small cell lung cancer patients (NSCLC) by comparative analysis the application of coregistered computed tomography (CT) and positron emission tomography (PET)/CT in non - small cell lung cancer radiotherapy. Methods Twenty - four NSCLC patients(median age: 47.5 ±11.0 years; range; 35-78years) referred to the 3D conformal radiotherapy (3D -CRT) were recruited, and conventional 18F -flu -orodeoxy glucose (18F FDG -PET)/CT scan. Two experienced radiologists analyzed the results of the examinations under double blindness, and analyzed the lesions size, shape, other inflammation swelling and other things, and to contoured 24 NSLC patients CT-GTV, PET/CT-GTV. Two radiologists use the same computer software. Sketch time, numbers of the sketching area, window width and enlargement of the multiples of each patients are identical by each radiologist. Then from two oncology a doctor, separately executive CTV sketched directing by CT and PET/CT and then formulated treatment planning. Results Four cases were changing to palliative care as PET/CT found to be metastasis or mass excessive size . 15 cases PET/CT - GTV variation scope is over 25% than CT - GTV, increasing of 9 cases ( growth rate 27% -102 ), decreasing of 6 cases (declined 36 -55% ) ;only 5 cases GTV variation scope small than 25%. It is now clear that PET/CT scan could change NSCLC patients radiotherapy regimens, decrease the difference of physicians for the influence 3DCRT therapy planning. Conclusion 18F - FDG/CT could effectively decrease the influence of human element, sketche NSCLC radiotherapy planning target area more precise and develop the accuracyof 3DCRT.%目的 通过对非小细胞肺癌( NSCLC) CT和经济型PET/CT的影像学特点进行对比分析,探讨经济型PET/CT在NSCLC患者放疗方案制定中的价值.方法24例拟进行3D适型放射治疗的NSCLC患者,平均年龄(47.5±11.0)岁,常规行18F- FDG经济型PET/CT扫描.由2名影像学医师使用双盲法对患者检查结果进行图像分析,了解其病灶大小、形态、周围水肿、炎症及其他情况等,然后对24例NSCLC患者进行CT - GTV和18F - FDG经济型PET/CT - GTV勾画.2名医师的勾画时间、勾画区域、数目、窗宽及放大倍数等条件均保持一致.再由2名肿瘤科医师分别进行CT和18F -FDG经济型PET/CT指导的GTV勾画,并以此结果制定治疗方案.结果4例由于18F - FDG经济型PET/CT发现了转移或肿块体积过大而改为姑息性放疗；15例PET/CT - GTV较CT - GTV变化幅度超过25％,其中9例增大(增幅27％～102％),6例减小(降幅36％～55％)；仅有5例GTV变化幅度小于25％.18F - FDG经济型PET/CT显像使24例患者中19例改变了放疗方案(19/24,79.1％).结论经济型PET/CT能够更准确勾画NSCLC放射治疗计划靶区,从而提高3DCRT靶区精度防止病灶遗漏.18F - FDG经济型PET/CT显像的应用对指导NSCLC患者放疗方案的合理制定有较大价值.
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