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首页> 外文期刊>Endoscopy International Open >Fiducial markers coupled with 3D PET/CT offer more accurate radiation treatment delivery for locally advanced esophageal cancer
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Fiducial markers coupled with 3D PET/CT offer more accurate radiation treatment delivery for locally advanced esophageal cancer

机译：基准标记与3D PET / CT结合可为局​​部晚期食管癌提供更准确的放射治疗

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Background and aims The role of three-dimensional positron emission tomography/computed tomography (3?D PET/CT) in esophageal tumors that move with respiration and have potential for significant mucosal inflammation is unclear. The aim of this study was to determine the correlation between gross tumor volumes derived from 3?D PET/CT and endoscopically placed fiducial markers. Methods This was a retrospective, IRB approved analysis of 40 patients with esophageal cancer with fiducials implanted and PET/CT. The centroid of each fiducial was identified on PET/CT images. Distance between tumor volume and fiducials was measured using axial slices. Image features were extracted and tested for pathologic response predictability. Results The median adaptively calculated threshold value of the standardized uptake value (SUV) to define the metabolic tumor volume (MTV) border was 2.50, which corresponded to a median 23?% of the maximum SUV. The median distance between the inferior fiducial centroid and MTV was –?0.60?cm (–?3.9 to 2.7?cm). The median distance between the superior fiducial centroid and MTV was 1.25?cm (–?4.2 to 6.9?cm). There was no correlation between MTV-to-fiducial distances greater than 2?cm and the gastroenterologist who performed the fiducial implantation. Eccentricity demonstrated statistically significant correlations with pathologic response. Conclusions There was a stronger correlation between inferior fiducial location and MTV border compared to the superior extent. The etiology of the discordance superiorly is unclear, potentially representing benign secondary esophagitis, presence of malignant nodes, inflammation caused by technical aspects of the fiducial placement itself, or potential submucosal disease. Given the concordance inferiorly and the ability to more precisely set up the patient with daily image guidance matching to fiducials, it may be possible to minimize the planning tumor volume (PTV) margin in select patients, thereby, limiting dose to normal structures. Comment to this article: Endoscopy International Open – recently published Endoscopy 2017; 49(07): 723-723DOI: 10.1055/s-0043-111207
机译：背景与目的三维正电子发射断层扫描/计算机断层扫描（3D PET / CT）在食道肿瘤中的作用尚不清楚，食道肿瘤随着呼吸而移动，并可能引起严重的粘膜炎症。这项研究的目的是确定源自3D PET / CT的总肿瘤体积与内镜下放置的基准标记之间的相关性。方法这是一项经IRB批准的回顾性分析，对40例食管癌患者进行了基准点植入和PET / CT检查。在PET / CT图像上确定了每个基准的质心。使用轴向切片测量肿瘤体积和基准之间的距离。提取图像特征并测试病理反应的可预测性。结果定义代谢肿瘤体积（MTV）边界的标准化摄取值（SUV）的自适应计算阈值的中位数为2.50，相当于最大SUV的中位数23％。下基准质心与MTV之间的中位距离为–0.60？cm（–3.9至2.7？cm）。基准上心与MTV之间的中位距离为1.25？cm（–4.2至6.9？cm）。 MTV至基准距离大于2？cm与执行基准植入的肠胃病医生之间没有相关性。离心率显示出与病理反应的统计学显着相关性。结论下位基准位置与MTV边界之间的相关性高于上位。不一致的病因尚不清楚，可能代表良性继发性食管炎，恶性淋巴结的存在，由基准放置本身的技术方面引起的炎症或潜在的粘膜下疾病。较差的协调性和通过基准图像匹配每日影像指导来更精确地设置患者的能力，有可能使所选患者的计划肿瘤体积（PTV）边缘最小化，从而将剂量限制在正常结构内。对本文的评论：内窥镜国际公开赛–最近出版的《内窥镜检查2017》; 49（07）：723-723DOI：10.1055 / s-0043-111207

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