| 章钰梅,巩贯忠,曹秀娟,等.基于CT/MRI/PET-CT进行鼻咽癌大体肿瘤区及淋巴结勾画的对照研究[J].中华放射医学与防护杂志,2021,41(9):653-658.Zhang Yumei,Gong Guanzhong,Cao Xiujuan,et al.A comparative study on the delineation of gross tumor volume and lymph nodes of nasopharyngeal carcinoma patients using CT/MRI/and PET-CT[J].Chin J Radiol Med Prot,2021,41(9):653-658 |
| 基于CT/MRI/PET-CT进行鼻咽癌大体肿瘤区及淋巴结勾画的对照研究 |
| A comparative study on the delineation of gross tumor volume and lymph nodes of nasopharyngeal carcinoma patients using CT/MRI/and PET-CT |
| 投稿时间：2020-12-08 |
| DOI：10.3760/cma.j.issn.0254-5098.2021.09.003 |
| 中文关键词: 鼻咽肿瘤 计算机体层成像 磁共振成像 正电子发射计算机断层显像 |
| 英文关键词:Nasopharyngeal neoplasms Computerized tomography Magnetic resonance imaging Positron emission computed tomography |
| 基金项目:山东省自然科学基金（ZR2020MH227）；广西重点研发计划（AB17195005） |
| 作者 | 单位 | E-mail | | 章钰梅 | 西南医科大学临床医学院, 泸州 646000 | | | 巩贯忠 | 山东省肿瘤防治研究院(山东省肿瘤医院), 山东第一医科大学(山东省医学科学院)放疗科, 济南 250117 | | | 曹秀娟 | 山东省肿瘤防治研究院(山东省肿瘤医院), 山东第一医科大学(山东省医学科学院)放疗科, 济南 250117 | | | 韩云炜 | 西南医科大学临床医学院, 泸州 646000 | | | 周静 | 山东省肿瘤防治研究院(山东省肿瘤医院), 山东第一医科大学(山东省医学科学院)放疗科, 济南 250117 | | | 陆合明 | 广西壮族自治区人民医院放疗科, 南宁 530021 | | | 尹勇 | 西南医科大学临床医学院, 泸州 646000 | yinyongsd@126.com |
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| 中文摘要: |
| 目的 比较基于计算机体层成像（CT）、磁共振成像（MRI）、18氟-脱氧葡萄糖正电子发射计算机断层显像（18F-FDG PET-CT）3种图像勾画鼻咽癌（NPC）大体肿瘤靶区（GTV）及淋巴结的差异，并以MRI为参考研究基于PET自动勾画NPC GTV的最佳标准摄取值（SUV）。方法 选取拟行放疗的鼻咽癌患者53例，依次获得CT模拟定位、MRI模拟定位及PET图像，在3种图像上分别勾画GTV与阳性淋巴结，分别命名为GTVMRI、GTVCT、GTVPET2.5（SUV=2.5）、LymphMRI、LymphCT、LymphPET2.5，比较不同图像确定的GTV及淋巴结差异。将MRI与PET-CT配准后，得到相交区域GTV∩2.5，依据SUV=4.0、4.5、5.0、5.6为阈值分别在PET上自动勾画GTVPET4.0、GTVPET4.5、GTVPET5.0、GTVPET5.6，比较不同GTV之间体积、相似系数（DSC）的差异。结果 在3种图像中，GTVMRI分别较GTVCT增加了1.73%（P>0.05），较GTVPET2.5减小了21.34%（t=-3.52，P<0.05）；LymphPET2.5的体积分别为LymphMRI、LymphCT的1.61、1.87倍（t=-4.12、-5.18，P<0.05）。PET上表现为高摄取的淋巴结体积平均为无或低摄取的4.07倍（t=5.50，P<0.05）。GTVPET4.0与GTVMRI的DSC为0.78±0.27，低于GTVPET2.5与GTVMRI的DSC （0.84±0.18），但GTVPET4.0与GTV∩2.5体积基本相当（P>0.05）。结论 基于CT、MRI、18F-FDG PET-CT勾画鼻咽癌GTV及淋巴结时，MRI可更好显示肿瘤边界；而基于18F-FDG PET-CT自动勾画GTV时，推荐SUV=4.0作为阈值。 |
| 英文摘要: |
| Objective To compare the differences in the delineation of the gross tumor volume (GTV) and lymph nodes of nasopharyngeal carcinoma (NPC) patients using computerized tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), and to investigate the optimal standard uptake value (SUV; relative to the MRI-based delineation) for the automatic delineation of GTV using PET. Methods A total of 53 NPC patients proposing to receive radiotherapy were selected for this study. The CT, MRI, and PET images of each patient were obtained before radiotherapy. Then GTV and positive lymph nodes were delineated on these three types of images. They were individually named GTVMRI, GTVCT, GTVPET2.5 (SUV=2.5), LymphMRI, LymphCT, and LymphPET2.5 and compared. The GTV∩2.5 (overlapped GTV) was obtained through the alignment of MRI and PET/CT images. Meanwhile, GTV was delineated on PET images using thresholds of SUV=4.0, 4.5, 5.0, and 5.6, obtaining GTVPET4.0, GTVPET4.5, GTVPET5.0, and GTVPET5.6. Then their volume and Dice similarity coefficients (DSCs) were compared. Results Compared to GTVMRI, GTVCT decreased by 1.73% (P>0.05) and GTVPET2.5 increased by 21.34% (t=-3.52, P < 0.05) in the three types of images. The volume of LymphPET2.5 was 1.61 and 1.87 times the volume of LymphMRI and LymphCT, respectively (t=-4.12, -5.18; P< 0.05). The volume of high-SUV lymph nodes was 4.07 times the volume of lymph nodes with low SUVs or SUV=0 (t=5.50, P< 0.05) on PET images. The DSC between GTVPET4.0and GTVMRI was 0.78 ±0.27, which was lower than that between GTVPET2.5 and GTVMRI (0.84 ±0.18). However, GTVPET4.0 approximated to GTV∩2.5 (P>0.05). Conclusions Compared to CT and 18F-FDG PET/CT, MRI shows more accurate boundaries of GTV and lymph nodes. When 18F-FDG PET/CT was adopted to automatically delineate GTV, the GTV delineated using SUV=4.0 was closer to GTVMRI. |
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