Spatial dynamic distribution and stability of<sup>18</sup>F-FDG uptake locations within primary tumor during radiotherapy for esophageal squamous cell carcinoma

刘　琪; 余　雯; 蔡旭伟

doi:10.3969/j.issn.1007-3969.2016.02.008

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Spatial dynamic distribution and stability of¹⁸F-FDG uptake locations within primary tumor during radiotherapy for esophageal squamous cell carcinoma

更新时间：2025-12-31

- Spatial dynamic distribution and stability of¹⁸F-FDG uptake locations within primary tumor during radiotherapy for esophageal squamous cell carcinoma
- China Oncology Vol. 26, Issue 2, Pages: 161-167(2016)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院放射治疗中心，复旦大学上海医学院肿瘤学系,上海,200032
  2. 上海交通大学附属胸科医院放疗科,上海,200030
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2016.02.008
  CLC：
- Published Online：01 June 2016，
  
  Published：01 June 2016
- 稿件说明：
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刘　琪,余　雯,蔡旭伟,等. PET-CT用于评价食管鳞癌放疗中

刘　琪, 余　雯, 蔡旭伟. Spatial dynamic distribution and stability of¹⁸F-FDG uptake locations within primary tumor during radiotherapy for esophageal squamous cell carcinoma[J]. China Oncology, 2016, 26(2): 161-167.
刘　琪,余　雯,蔡旭伟,等. PET-CT用于评价食管鳞癌放疗中 DOI： 10.3969/j.issn.1007-3969.2016.02.008.

刘　琪, 余　雯, 蔡旭伟. Spatial dynamic distribution and stability of¹⁸F-FDG uptake locations within primary tumor during radiotherapy for esophageal squamous cell carcinoma[J]. China Oncology, 2016, 26(2): 161-167. DOI： 10.3969/j.issn.1007-3969.2016.02.008.

摘要

背景与目的：放疗为食管癌重要的治疗方式之一，但疗效并不理想。目前认为肿瘤在PET-CT上高摄取的区域可能与放射抵抗有关。本文通过观察放疗前和放疗中两次PET-CT所显示的食管原发病灶

F-FDG高摄取区域的空间位置关系，从而推测依据放疗前的PET图像上所显示的食管癌原发灶高

F-FDG摄取的信息进行区域选择性加量放疗的可行性。方法：入组2011—2013年在复旦大学附属肿瘤医院放疗科接受同步放化疗治疗的初治食管鳞癌患者。所有患者在放疗前和放疗40 Gy时(第2次同步化疗前)分别行

F-FDG PET-CT扫描。在第1次PET图像上原发灶勾画首先以标准摄取值(standard uptake value，SUV)=2.5、5和40%~70%SUV

max-pre

为阈值在PET图像上自动勾画得到大体肿瘤体积(gross tumor volume，GTV)

2.5pre

、GTV

5pre

、GTV

40%pre

、GTV

50%pre

、GTV

60%pre

和GTV

70%pre

。在第2次PET图像上，以SUV=2.5和70%~90%SUV

max-dur

为阈值勾画得到GTV

2.5dur

、GTV

70%dur

、GTV

80%dur

和GTV

90%dur

。计算两次PET图像上以阈值自动勾画的区域的空间交集分数(overlap fraction，OF)，即两个感兴趣区(region of interest，ROI)的交集的体积与两个ROI相对较小的体积的比值。结果：共入组22例患者。所有患者的原发灶SUV

max

、SUV

mean

均有显著下降(P=0.003和P0.0001)。残留高摄取区域与治疗前GTV

50%pre

的OF达到70%以上，其中热点区域GTV

90%dur

完全处于原发灶的高摄取区域内，OF达到100%。以不同阈值勾画的体积有很大差异，而放疗前和放疗中的食管癌原发灶高代谢区域尽管体积变化很大，但空间位置保持相对的稳定。结论：放疗中食管鳞癌原发灶的SUV显著下降，但食管癌原发灶残留的

F-FDG高摄取区域仍然较稳定的落在治疗前原发灶GTV及治疗前PET上所显示的

F-FDG高摄取区域内，提示依据治疗前PET图像来选择性对食管癌原发病灶的部分区域进行局部加量放疗是可行的。

Abstract

Background and purpose: Radiotherapy (RT) is one of the most important therapeutic tools for esophageal cancer. Because tumors are heterogeneous

including for

F-FDG uptake and

most likely

for radioresistance

selective boosting of high FDG uptake zones within the tumor has been suggested. Therefore

it is critical to know whether the location of these high FDG uptake patterns within the tumor remains stable during RT. Methods: Twenty-two patients with esophageal squamous cell carcinoma treated with concurrent chemo-radiation underwent repeated

F-FDG PET-CT scans before RT and after 20 fractions of RT. On all scans

the high and low FDG uptake regions were auto-delineated using several standard uptake value (SUV) thresholds

varying from 40% to 70% of SUV

max

on the pretreatment scan [gross tumor volume (GTV)

40%pre

GTV

50%pre

GTV

60%pre

GTV

70%pre

]

and from 70% to 90% of SUVmax on the dur-treatment scan (GTV

70%dur

GTV

80%dur

GTV

90%dur

) and fixed thresholds of 2.5 and 5 (GTV

2.5pre

GTV

5pre

). The volumes and overlap fractions (OF) of these delineations were calculated to demonstrate the stability of the high FDG uptake regions during RT. Results: The high uptake regions within the tumor during RT largely corresponded (OF70%) with the 50% SUV

max

high FDG uptake area (GTV

50%pre

) of the pretreatment scan. The hotspot within the residual area (GTV

90%dur

) was completely within the GTV and pre-radiotherapy high uptake regions (OF=100%). Although the location of the high FDG uptake patterns within the tumor during RT remained stable

the delineated volumes varied markedly. Conclusion: The location of the high FDG uptake areas within the tumor remained stable during RT. This knowledge may enable selective boosting of high FDG uptake areas within the tumor.

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Related Author

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Related Institution

Department of Oncology, Taiyuan Central Hospital/The Ninth Clinical Medical College of Shanxi Medical University

Department of Thoracic Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University

Department of Radiation Oncology, Fudan University Huadong Hospital

Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University

Department of Radiotherapy, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University

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Spatial dynamic distribution and stability of18F-FDG uptake locations within primary tumor during radiotherapy for esophageal squamous cell carcinoma

DOI：10.3969/j.issn.1007-3969.2016.02.008

摘要

Abstract

关键词

Keywords

references

Spatial dynamic distribution and stability of¹⁸F-FDG uptake locations within primary tumor during radiotherapy for esophageal squamous cell carcinoma