| Part one 18F-FDG PET/CT was compared to MRI in the stage of nasopharyngeal carcinoma Objective:The accurate staging of nasopharyngeal cancer plays an important role in guiding the selection of treatment options.In this study,the application value of18F-FDG PET/CT imaging in the stage of nasopharyngeal carcinoma was discussed in this study by comparing the imaging results of18F-FDG PET/CT and MRI in patients with nasopharyngeal carcinoma.Methods:Collected in October 2014-December 2014,our hospital confirmed by pathology or cytology for 84 cases of patients with nasopharyngeal carcinoma(NPC),the Angle of the sexual differentiation carcinoma in 48 cases,non cornification undifferentiated carcinoma in 36 cases;Men 59,25 women,aged 12 to 79(median age 43);Nasopharyngeal carcinoma patients were performed 18F-FDG PET/CT and MRI,18F-FDG PET/CT with the method of semi-quantitative analysis according to the standard values taken largest SUVmax acuity 2.5 for positive judgment standard staging the lesion site;The MRI was assessed by the size of the primary lesion and the extent of the area of the surrounding tissue,the size of the lymph nodes,and the amount of the lymph nodes.Using SPSS19.0 software with the result of different pathological classification SUV values of nasopharyngeal carcinoma,statistical analysis to mean ± standard(???±s)said,using t test were compared between the twogroups,P < 0.05 for difference is statistically significant.Results:1.The changes of TNM staging in nasopharyngeal carcinoma by 18F-FDG,PET/CT and MRI:18F-FDG PET/CT compared with MRI imaging staging,18F-FDG PET / CT imaging,45%(38/84)patients staging changes: staging up 27 cases,T staging in 7cases(4 cases of T1 Increased to T2,T2 T2 increased to T3,T3 T3 increased to T4),N staging in 8 cases(1 case of N0 increased to N1,3 cases of N1 increased to N2,4cases of N2 rose to N3),M staging in 12 cases(3 cases of lung metastasis,2 cases of liver metastasis,7 cases of bone metastasis);11 cases of staging,5 cases of T4 decreased to T3 4 cases of N2 decreased to N1,2 cases N2 dropped to N0.2.Difference of SUV values in different pathological types of nasopharyngeal carcinoma:There were 48 cases with non keratotic differentiation,SUV max(19.24 ±10.44),36 cases of non-keratinized undifferentiated carcinoma and SUV max(24.83± 11.05),the difference was statistically significant(t = 2.37,P <0.05).Conclusions:1.18F-FDG PET/CT molecular imaging technology combines the advantages of anatomical and functional imaging in the diagnosis of primary lesions of nasopharyngeal carcinoma,cervical metastatic lymph nodes and distant metastases than MRI conventional imaging method is more comprehensive and accurate Determine the clinical stage,the next step in the development of treatment programs have important guiding significance.2.18F-FDG PET/CT imaging in the semi-quantitative analysis of SUV max value and the degree of differentiation of nasopharyngeal carcinoma cells have a correlation,that is,the worse the degree of tumor cell differentiation,SUV max value is higher,the stronger the invasive.Part Two Differences of 18F-FDG PET/CT and MRI in the mapping of nasopharyngeal carcinoma radiotherapy targetObjective:By comparing the patients with nasopharyngeal carcinoma radiotherapy before18F-FDG PET/CT and MRI image sketch GTV,and compare the two kinds of target area after radiation therapy in the near future curative effect and adverse reaction,discusses18F-FDG PET/CT in nasopharyngeal carcinoma radiotherapy target outline the application value.Methods:1.Patients before radiotherapy were performed18F-FDG PET/CT and MRI,the nuclear medicine doctor and radiation,respectively by 18F-FDG PET/CT and MRI image target outline,GTVPET/CT using semi-quantitative analysis indicators SUV max?2.5 as the positive standard for automatic sketching;GTVMRI according to the international commission on radiation unit and the determination of the definition of50 and 62(ICRU)report,on T1 WI,T2WI scan and T1 WI enhancement scanning,and coronary,axial and sagittal displayed on primary focal range,on T1 WI enhanced shaft bit image of tumor target step by step a sketch.2.From 84 patients with nasopharyngeal carcinoma,there were 23 patients who had been treated with GTVPET/CT as the target area and the GTVPET/CT treatment group.In the clinical selection,29 patients with pure radiotherapy were treated by GTVMRI GTVMRI group.Two groups of patients before radiotherapy 1 week with three months after the end of radiotherapy of nasopharyngeal MRI enhancement scanning,the recent curative effect according to the WHO evaluate the therapeutic effect evaluation standard of solid tumors;The adverse reactions were recorded according to the evaluation criteria of the American cancer radiotherapy association(RTOG).Use SPSS19.0 software to compare the differences in GTV from 18F-FDG PET/CT and MRI.GTVPET/CT in treatment group and other GTVMRI treatment group after radiation therapy in the near future curative effect and adverse reaction of statistical analysis of the results of the measurement data with mean ± standard deviation(???±s),said the group comparison between using t test,counting data using percentage(%),said the group of comparison between the 2 test,P< 0.05 for difference is statistically significant.Results:Eighty-four patients with nasopharyngeal carcinoma 18F-FDG PET/CT and MRI showed the difference in GTVGTVPET/CT(27.24 ± 12.58 cm3)was smaller than that of GTVMRI(23.67 ± 17.63cm3),GTVPET/CT was about 27.17% lower than that of GTVMRI,P <0.05 was statistically significant.In this study,84 patients with nasopharyngeal carcinoma 61 cases of GTVPET/CT less than GTVMRI,23 cases of GTVPET/CT greater than GTVMRI.1.GTVPET/CT therapy group and GTVMRI were recently treated with radiation therapy and adverse reactions2.1 Recent efficacyBoth groups of patients with nasopharyngeal carcinoma within 1 week prior to radiotherapy and three months after the end of radiotherapy of nasopharyngeal MRI enhancement scanning,according to the WHO therapeutic effect evaluation standard of solid tumors,GTVPET/CT treatment group completely relieve the 21 cases(91.3%),and partial response in 2 cases(8.7%),no change in zero(0);The GTVMRI group had a total reduction of 25(86.21%),partial relief of 3(10.34%),no change(3.45%),and no statistically significant difference between P > 0.05.2.2 Adverse reactionsThe GTVPET/CT treatment group had 10 cases of skin reaction(43.48%),dry symptoms in 6(26.09%),mucous membrane response 3(13.04%),and 1 case(4.35)of the bone marrow response.The GTVMRI group had 21 cases of skin response(72.41%),17 cases(58.62%),and 12 cases(41.38%)of mucosa,and 7 cases(24.14%)of the bone marrow response.Therefore,the GTVPET/CT treatment group had a lower incidence of adverse reactions after radiation therapy than GTVMRI,and the difference in P < 0.05 was statistically significant.Conclusions:1.18F-FDG PET/CT imaging for the functional metabolism and anatomic image fusion,can accurately distinguish the tumor tissues and adjacent tissues surrounding anatomic relationship,precise guidance radiotherapy target outline for further plans to offer help,make up for the deficiency of conventional imaging examination method.2.18F-FDG PET/CT and MRI are two imaging methods sketch target in the near future curative effect of radiotherapy,but 18F-FDG PET/CT incidence of adverse reactions was lower than those of MRI,prompted by 18F-FDG PET/CT imaging of radiation therapy can effectively protect the target tumor and adjacent normal tissue around vital organs,improve patient quality of life. |
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