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随着肿瘤分子生物学和基因水平的研究发展,肺癌的精准分子靶向治疗及免疫治疗的研究和临床应用已成为当前肺癌治疗领域的热点,肺癌疗效的影像评估关系到患者治疗方案的调整和预后评价。基于传统影像学技术的实体瘤疗效评价标准(response evaluation criteria in solid tumors,RECIST)[1-2]广泛应用于实体肿瘤的疗效评估,但在肺癌的疗效评估中还存在一些不足。一些分子靶向治疗药物主要通过抑制肿瘤细胞来达到治疗目的,肿瘤的大小变化可能并不明显[3]。另外,解剖成像在鉴别肿瘤组织残余、术后疤痕和治疗引起的间质纤维化等方面的作用有限[4]。分子显像与肿瘤代谢显像技术(如18F-FDG PET/CT)主要通过肿瘤细胞对示踪剂的摄取变化反映肿瘤治疗前后生物学行为的改变,相应的PET实体瘤疗效标准(PET response criteria in solid tumors,PERCIST)[5]从肿瘤分子代谢层面评价肿瘤治疗效果,能够克服传统影像学技术的上述缺陷[6],为肺癌的疗效评估以及预后分析提供了新的方法及手段。
18F-FDG PET/CT在肺癌疗效评估中的价值
The value of 18F-FDG PET/CT on evaluating therapeutic effect in the treatment of lung cancer
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摘要: 肺癌的精准分子靶向及免疫治疗的研究和临床应用已成为当前肺癌治疗领域的热点。18F-FDG PET/CT是结合形态学与分子代谢的影像学技术,与传统的影像学检查如CT、MRI相比,18F-FDG PET/CT能够及时反映肿瘤细胞的活性,对指导肺癌的精准放化疗及监测疗效有重要价值。笔者主要就18F-FDG PET/CT在肺癌病灶的靶区勾画、疗效评估及预后评价中的价值进行探讨。
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关键词:
- 肺肿瘤 /
- 氟脱氧葡萄糖F18 /
- 正电子发射断层显像计算机体层摄影术 /
- 疗效评价
Abstract: In recent years, the clinical application of the precise molecular targeted therapy and immunotherapy of lung cancer has been a focus of lung cancer research. 8F-FDG PET/CT is an imaging technology that merges morphology and molecular metabolism. 18F-FDG PET/CT can provide timely information about the activities of tumor cells compared with traditional imaging technologies, such as CT and MRI, and has significant value on guiding precise radio-chemotherapy and monitoring treatment efficacy in lung cancer. This article will focus on the application of 8F-FDG PET/CT in lung cancer, particularly in the delineation of targeted lesion, evaluation of treatment effect, and prognosis evaluation. -
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