中华放射医学与防护杂志

郭延娈,李建彬,王玮,等.基于4D-CT的最大密度投影图像与基于PET-CT不同SUV值勾画的胸段食管癌原发肿瘤IGTV比较研究[J].中华放射医学与防护杂志,2014,34(9):683-687.,et al.Comparison of internal gross target volumes delineated on the maximum intensity projection of four-dimensional CT images and positron emission tomography-CT for primary thoracic esophageal cancer[J].Chin J Radiol Med Prot,2014,34(9):683-687

基于4D-CT的最大密度投影图像与基于PET-CT不同SUV值勾画的胸段食管癌原发肿瘤IGTV比较研究

Comparison of internal gross target volumes delineated on the maximum intensity projection of four-dimensional CT images and positron emission tomography-CT for primary thoracic esophageal cancer

投稿时间：2013-12-20

DOI：10.3760/cma.j.issn.0254-5098.2014.09.010

中文关键词: 胸段食管癌 ¹⁸F-FDG PET-CT 4D-CT 标准摄取值内大体肿瘤体积

英文关键词:Thoracic esophageal cancer ¹⁸F-FDG PET-CT Four-dimensional computed tomography Standardized uptake value Internal gross target volume

基金项目:

作者	单位	E-mail
郭延娈	250117 济南, 山东省肿瘤医院放疗三病区
李建彬	250117 济南, 山东省肿瘤医院放疗三病区	lijianbin@msn.com
王玮	250117 济南, 山东省肿瘤医院放疗三病区
王金之	250117 济南, 山东省肿瘤医院放疗三病区
李奉祥	250117 济南, 山东省肿瘤医院放疗三病区
段益利	250117 济南, 山东省肿瘤医院放疗三病区
尚东平	250117 济南, 山东省肿瘤医院大孔径CT室
付政	250117 济南, 山东省肿瘤医院PET-CT室

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中文摘要:

目的比较基于4D-CT的最大密度投影（MIP）图像与基于¹⁸F-FDG PET-CT不同SUV值勾画的胸段食管癌原发肿瘤靶区间的体积大小、适形指数（CI）和包含度（DI）。方法 15例胸段食管癌患者序贯完成3D-CT、4D-CT、¹⁸F-FDG PET-CT 胸部定位扫描。在4D-CT的MIP图像上勾画食管原发肿瘤的内大体肿瘤体积IGTV_MIP，在PET-CT的PET图像上分别选择不同SUV阈值（≥2.0、2.5、3.0、3.5）、最大SUV值（SUV_max）的不同百分比（≥20%、25%、30%、35%、40%）及人工视觉观察勾画食管原发肿瘤靶区。结果 IGTV_PET_2.5、IGTV_PET20%、IGTV_PETMAN与IGTV_MIP体积比值最接近于1，分别为0.86、0.88、1.06；IGTV_PET2.0、IGTV_PET2.5、IGTV_PET20%、IGTV_PET25%、IGTV_PETMAN与IGTV_MIP间CI分别为0.55、0.56、0.56、0.54、0.55，均明显大于其他IGTV_PET与IGTV_MIP间的CI 值（Z=-3.408~2.215，P<0.05）。IGTV_PET2.5、IGTV_PET20%、IGTV_PETMAN与IGTV_MIP相互间DI值分别为0.77、0.82、0.71和0.67、 0.68、0.82，差异均不明显（P >0.05）。结论基于PET图像SUV阈值2.5、最大SUV值的20%及人工视觉观察3种方法与基于4D-CT的MIP图像所勾画胸段食管癌原发肿瘤靶区体积大小最接近且空间错位相对较小。

英文摘要:

Objective To compare volumetric size, conformity index (CI), degree of inclusion (DI) of internal gross target volumes (IGTV) delineated on 4D-CT-MIP and PET-CT images for primary thoracic esophageal cancer. Methods Fifteen patients with thoracic esophageal cancer sequentially underwent enhanced 3D-CT, 4D-CT and PET-CT simulation scans. IGTV_MIP was obtained by contouring on 4D-CT maximum intensity projection (MIP). The PET contours were determined with nine different threshold methods (SUV≥ 2.0, 2.5, 3.0, 3.5), the percentages of the SUV_max(≥20%, 25%, 30%, 35%, 40%) and manual contours. The differences in size, conformity index (CI), degree of inclusion (DI) of different volumes were compared.Results The volume ratios (VRs) of IGTV_PET2.5 to IGTV_MIP, IGTV_PET20% to IGTV_MIP, IGTV_PETMAN to IGTV_MIP were 0 .86, 0.88, 1.06, respectively, which approached closest to 1. The CIs of IGTV_PET_2.0,IGTV_PET2.5,IGTV_PET20%,IGTV_PETMAN and IGTV_MIPwhich were 0.55, 0.56, 0.56, 0.54,0.55, respectively, were significantly larger than other CIs of IGTV_PET and IGTV_MIP(Z=-3.408-2.215,P<0.05). There were no statistical significance in the DIs of IGTV_MIP and IGTV_PET2.5,IGTV_MIP and IGTV_PET20%, IGTV_MIP and IGTV_PETMAN(0.77,0.82,0.71,0.67, 0.68,0.82,P>0.05).Conclusions The targets delineated based on SUV threshold setting of ≥2.5, 20% of the SUV_max and manual contours on PET images correspond better with the target delineated on maximum intensity projection of 4D-CT images than other SUV thresholding methods.

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