11C-蛋氨酸PET-CT在诊断脑胶质瘤复发和三维适形放疗靶区规划中的临床应用

于雷; 王莹莹; 车现锋; 孙爱君; 孙效刚

中国临床医学影像杂志 ›› 2013, Vol. 24 ›› Issue (6) : 385-388.

论著

11C-蛋氨酸PET-CT在诊断脑胶质瘤复发和三维适形放疗靶区规划中的临床应用

于雷，王莹莹，车现锋，孙爱君，孙效刚

作者信息 +

The application of 11C-MET PET-CT in diagnosing the recurrence of cerebral glioma and in the target volume planning of three-dimensional conformal radiotherapy

YU Lei, WANG Ying-ying, CHE Xian-feng, SUN Ai-jun, SUN Xiao-gang

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文章历史 +

摘要

目的：探讨11C-蛋氨酸PET-CT在复发胶质瘤的诊断以及放射治疗靶区规划中的临床价值。方法：对22例经头颅MRI增强扫描诊断为复发的胶质瘤患者行11C-蛋氨酸PET-CT检查，并通过开颅手术及活检获得病理；对12例病理证实复发病例利用PET-CT图像与MRI图像结合勾画靶区行三维适形放疗。结果：22例患者11C-蛋氨酸PET-CT显像真阳性16例，真阴性5例，假阳性1例，假阴性0例，灵敏度95.5％（21/22），特异性83.3％（5/6），假阳性率16.7％（1/6），假阴性率0，约登指数0.788；12例病理确诊复发者行三维适形放疗，4例靶区与T1WI增强区一致，2例靶区范围大于T1WI增强区，4例靶区范围小于T1WI增强区，2例靶区完全位于T1WI增强区之外。结论：11C-蛋氨酸PET-CT对诊断胶质瘤复发的准确性高，可用于MRI/CT诊断复发而临床尚不确诊病例的诊断；并能明显优化胶质瘤复发患者的放疗计划。

Abstract

Objective: To study the clinical value of 11C-MET PET-CT in the diagnosis of recurrent glioma and in planning radiation therapy target. Method: 11C-MET PET-CT examination was used in 22 glioma patients with cranial MRI enhanced scan diagnosed recurrence, pathological diagnosis obtained by craniotomy and biopsy, the three-dimensional conformal radiotherapy target was sketched using the combination of PET-CT images and MR images in 12 cases with pathologically confirmed recurrence. Results: PET-CT imaging of 22 patients with 11C-MET: true positive 16 cases, true negative 5 cases, false positive 1 case and no false negative cases, the sensitivity was 95.5%(21/22), the specificity was 83.3%(5/6), the false-positive rate was 16.7%(1/6), the false-negative rate was 0, Youden index 0.788; 12 patients with histologically confirmed recurrence were given the three-dimensional conformal radiotherapy, target range of 4 cases was consistent with T1WI enhanced region, 2 cases was greater than T1WI enhanced region, four cases was less than T1WI enhanced region, the target range of 2 cases located entirely outside T1WI enhanced region. Conclusion: 11C-MET PET-CT has a high accuracy in the diagnosis of glioma recurrence, can be used in cases of MRI/CT diagnosis of recurrent, but the clinical diagnosis is not yet confirmed, and can obviously optimize radiotherapy planning in patients with glioma recurrence.

导出引用

于雷;王莹莹;车现锋;孙爱君;孙效刚. 11C-蛋氨酸PET-CT在诊断脑胶质瘤复发和三维适形放疗靶区规划中的临床应用[J]. 中国临床医学影像杂志. 2013, 24(6): 385-388

YU Lei;WANG Ying-ying;CHE Xian-feng;SUN Ai-jun;SUN Xiao-gang. The application of 11C-MET PET-CT in diagnosing the recurrence of cerebral glioma and in the target volume planning of three-dimensional conformal radiotherapy[J]. Journal of China Clinic Medical Imaging. 2013, 24(6): 385-388

中图分类号： Ｒ739.41 Ｒ730.264 Ｒ817.4 Ｒ814.42