11C-MET PET/CT在高级别脑胶质瘤适形放疗方案制定中的价值

摘要

目的 对比MRI检查结果,探讨11C-MET PET/CT对高级别脑胶质瘤适形放疗方案制定的影响及价值.方法 回顾性研究2011年10月至2013年9月间经病理证实的25例初诊及9例复发的脑胶质瘤患者(男19例,女15例),所有患者均行11C-MET PET/CT及增强MRI检查,并分为初诊未手术组(17例)、初诊手术组(8例)、复发组(9例)3组,利用PET/CT图像勾画GTV并与MRIT1加权成像(T1WI)影像对比.结果 11C-MET PET/CT的应用优化了22例患者的放疗靶区,其中初诊未手术组7例,初诊手术组8例,复发组7例.初诊未手术组中,GTV与MRIT1WI异常强化体积(VMRI)一致者10例,GTV大于VMRI者5例,GTV小于VMRI者2例;初诊手术组中,GTV均小于VMRI;复发组中,GTV与VMRI一致者2例,GTV大于VMRI者2例,GTV小于VMRI者4例,1例GTV大部分位于VMRI之外.结论 11C-MET PET/CT对高级别胶质瘤病变范围的显示与MRI异常强化范围存在一定差异,结合11C-MET PET/CT勾画放疗靶区能明显优化高级别胶质瘤患者的放疗计划,对术后及复发病例应用价值可能更大.%Objective To explore the impact and value of 11C-MET PET/CT for high-grade glioma in making conformal radiotherapeutic planning compared with MRI.Methods From October 2011 to September 2013,11C-MET PET/CT and MRI were performed in 25 initial glioma cases and 9 recurrent cases.All 34 cases (19 males,15 females) were classified into initial group (n=17),initial surgery group (n=8) and recurrent group (n=9).GTV was outlined using PET/CT images combined with T1 weighted MRI images.Results 11 C-MET PET/CT optimized radiotherapy targets in 22 cases,including 7 initial cases,8 initial surgery cases and 7 recurrent cases.GTV was consistent with the volume of abnormally enhanced region on T1 weighted MRI (VMRI) in 10 initial cases,GTV＞VMRI in 5 cases,and GTV＜VMRI in 2 cases.GTV＜VMR1 in the initial surgery group.GTV was consistent with VMRI in 2 recurrent cases,GTV＞VMRI in 2 cases and GTV＜VMRI in 4 cases; 1 recurrent case's GTV located largely outside the VMRI.Conclusions There are some differences on locating the lesions of high-grade gliomas between 11C-MET PET/CT and MRI.Using 11CMET PET/CT in sketching radiotherapy target could significantly optimize the high grade glioma's radiotherapeutic planning,which may be more valuable in recurrent or operative cases.