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首页> 外文期刊>Technology in cancer research & treatment. >The impact of hybrid PET-CT scan on overall oncologic management, with a focus on radiotherapy planning: a prospective, blinded study.
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The impact of hybrid PET-CT scan on overall oncologic management, with a focus on radiotherapy planning: a prospective, blinded study.

机译：混合PET-CT扫描对整体肿瘤管理的影响，重点在于放射治疗计划：一项前瞻性，盲目的研究。

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Functional imaging using fluorodeoxyglucose positron-emission tomography (FDG-PET) has been increasing incorporated into radiotherapy planning in conjunction with computed tomography (CT). Hybrid FDG-PET/CT scanners allow these images to be obtained in very close temporal proximity without the need for repositioning patients, thereby minimizing imprecision when overlying these images. To prospectively examine the impact of hybrid PET/CT imaging on overall oncologic impact, with a focus on radiotherapy planning, we performed a prospective, blinded trial in 111 patients. Patients with lung cancer (n=38), head-and-neck squamous cell carcinoma (n=23), breast (n=8), cervix (n=15), esophageal (n=9), and lymphoma (n=18) underwent hybrid PET/CT imaging at the time of radiation therapy planning. A physician blinded to the PET dataset designed a treatment plan using all clinical information and the CT dataset. The treating physician subsequently designed a second treatment plan using the hybrid PET/CT dataset. The two treatment plans were compared to determine if a major alteration in overall oncologic management occured. In patients receiving potentially curative radiotherapy the concordance between CT-based and PET/CT-based GTVs was quantified using an index of conformality (CI). In 76/111 (68%) of patients, the PET/CT data resulted in a change in one or more of the following: GTV volume, regional/local extension, prescribed dose, or treatment modality selection. In 35 of these 76 cases (46%; 31.5% of the entire cohort) the change resulted in a major alteration in the oncologic management (dose, field design, or modality change). Thus, nearly a third of all cases had a major alteration in oncologic management as a result of the PET/CT data, and 29 of 105 patients (27.6%) who underwent potentially curative radiotherapy had major alterations in either dose or field design. Hybrid PET/CT imaging at the time of treatment planning may be highly informative and an economical manner in which to obtain PET imaging, with the dual goals of staging and treatment planning.
机译：使用氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）的功能成像已越来越多地结合计算机断层扫描（CT）纳入放射治疗计划。混合FDG-PET / CT扫描仪可以在非常近的时间范围内获取这些图像，而无需重新放置患者，从而将覆盖这些图像时的不精确度降至最低。为了前瞻性检查混合PET / CT成像对整体肿瘤学影响的影响，重点放在放射治疗计划上，我们对111例患者进行了一项前瞻性，盲法试验。患有肺癌（n = 38），头颈鳞状细胞癌（n = 23），乳腺癌（n = 8），宫颈（n = 15），食道癌（n = 9）和淋巴瘤（n = 18）在放射治疗计划时进行了PET / CT混合成像。不了解PET数据集的医师使用所有临床信息和CT数据集设计了治疗计划。主治医生随后使用混合PET / CT数据集设计了第二个治疗计划。比较了两种治疗计划，以确定总体肿瘤管理是否发生重大变化。在接受潜在放射治疗的患者中，使用保形指数（CI）量化了基于CT和基于PET / CT的GTV之间的一致性。在76/111（68％）的患者中，PET / CT数据导致以下一项或多项改变：GTV量，区域/局部扩展，处方剂量或治疗方式选择。在这76例病例中的35例（46％;整个队列的31.5％）中，这种改变导致了肿瘤治疗的重大改变（剂量，领域设计或模式改变）。因此，由于PET / CT数据的原因，几乎所有病例中有近三分之一的病例在肿瘤管理上有重大改变，在接受潜在治愈性放疗的105例患者中，有29例（27.6％）在剂量或野外设计上都有重大改变。治疗计划制定时的混合PET / CT成像可能具有很高的信息量，并且是获得PET成像的一种经济方式，具有分期和治疗计划的双重目标。

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