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目的探讨正电子发射断层扫描(PET)在胶质瘤间质内放射治疗后疗效观察及预后评价中的作用。方法对21例胶质瘤病人行131I间质内放射治疗,在治疗后6个月行MRI和18F-脱氧葡萄糖(18F-FDG)PET随访,并行病理活检,对比分析PET与MRI影像改变与肿瘤疗效及复发的关系。结果9例18F-FDGPET显示为局部病变区葡萄糖代谢增高,肿瘤/白质(T/WM)比值为2.79±0.20;7例显示为放射性缺损,T/WM值为0.81±0.12;5例显示病变区18F-FDG浓聚无明显改变,T/WM值为1.35±0.17。其中假阴性1例,假阳性1例。MRI难以诊断放疗后脑坏死、残存肿瘤或肿瘤复发8例。与病理活检比较,PET诊断准确率为90.5%,MRI为61.9%。结论18F-FDGPET在胶质瘤间质内放疗后区分放射性坏死与肿瘤复发方面较MRI更敏感而准确。
Objective To investigate the effect of positron emission tomography (PET) after radiotherapy in gliomas and the prognostic value. Methods Twenty-one patients with glioma underwent 131I interstitial radiation therapy. MRI and 18F-FDG PET were followed up at 6 months after treatment. Pathological biopsy was performed. The changes of PET and MRI were compared with those of tumor Efficacy and relapse. Results Nine cases of 18F-FDG PETET showed increased glucose metabolism, with a T / WM ratio of 2.79 ± 0.20. Seven cases showed radioactive defect with a T / WM value of 0.81 ± 0.12. Five cases showed lesions 18F-FDG concentration did not change significantly, T / WM value of 1.35 ± 0.17. One case of false negative, false positive in 1 case. MRI is difficult to diagnose radiotherapy brain necrosis, residual tumor or tumor recurrence in 8 cases. Compared with pathological biopsy, PET diagnostic accuracy was 90.5%, MRI was 61.9%. Conclusions 18F-FDG PET is more sensitive and accurate than MRI in discriminating between radioactive necrosis and tumor recurrence after radiotherapy in gliomas.