The Journal of Korean Society for Radiation Therapy (대한방사선치료학회지)

Korean Society for Radiation Therapy (대한방사선치료학회)
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The Usefulness of Integrated PET/CT Simulator for Non-Small Cell Lung Cancer Using the F-18 Fluoro-2-deoxyglucose (FDG)

포도당 유도체 불소화합물(FDG)을 이용한 비소세포폐암의 Integrated PET/CT 전산화 모의치료기에 대한 유용성 평가

  • Na, Jong Eok (Department of Radiation Oncology, Asan Medical Center) ;
  • Suh, Jeong Nam (Department of Radiation Oncology, Asan Medical Center) ;
  • Kim, Jin Soo (Department of Radiation Oncology, Asan Medical Center) ;
  • Kim, Dae Seob (Department of Radiation Oncology, Asan Medical Center) ;
  • Hong, Dong Ki (Department of Radiation Oncology, Asan Medical Center) ;
  • Baek, Geum Mun (Department of Radiation Oncology, Asan Medical Center)
  • 나종억 (서울아산병원 방사선종양학과) ;
  • 서정남 (서울아산병원 방사선종양학과) ;
  • 김진수 (서울아산병원 방사선종양학과) ;
  • 김대섭 (서울아산병원 방사선종양학과) ;
  • 홍동기 (서울아산병원 방사선종양학과) ;
  • 백금문 (서울아산병원 방사선종양학과)
  • Received : 2013.02.18
  • Accepted : 2013.03.10
  • Published : 2013.03.31
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Abstract

Purpose: To evaluate the usefulness of Integrated PET/CT and compare the gloss tumor volume (GTV) identified on CT, PET, PET/CT to that obtained from fluorodeoxyglucose (FDG). Materials and Methods: This experimental study was obtained using GE Discovery 690 (General Electric Healthcare, Milwaukee, MI, USA) PET/CT simulator with Gammex Laser System for five non-small cell lung cancer (NSCLC) patients. In order to increase the reproducibility of the patient setup, We have to fixed to patients using the Extended Wing Board. GTV delineation was painted using the EclipseTM ver.10 contouring program for CT, PET, PET/CT images. And then, We were to compare the changes in the GTV. Results: These results are drawn from 5 patients who have atelectasis or pneumonitis. Compared to CT defined GTV, PET was decreased by 10.5%, 11.8% and increased by 67.9%, 220%, 19.4%. PET/CT was decreased by 7.7%, 6.7%, 28% and increased by 232%, 24%. Conclusion: We were able to determine the usefulness of PET/CT simulator for NSCLC. PET/CT simulator in radiation therapy is useful to define the target volume and It is possible to delineate Objective and accurate target volume. It seems to be applicable to other areas in the near future.

목 적: 최근 Integrated PET/CT (GE Discovery 690, General Electric Healthcare, Milwaukee, MI, USA, 이하 PET/CT) 전산화 모의치료기가 방사선치료에 적용되면서 정확한 표적용적(Target Volume, TV)의 묘사가 가능하게 되었다. 본 연구에서는 포도당 유도체 불소화합물(F-18 fluoro-2-deoxyglucose, FDG)을 이용한 비소세포폐암 환자의 육안적표적용적(Gloss Target Volume, GTV)을 비교하여 유용성을 평가하고자 한다. 대상 및 방법: 가멕스 레이져 시스템(GAMMEX INC, Middleton, WI, USA)이 설치된 PET/CT를 이용하여 비소세포폐암 환자 5명을 대상으로 입체모의치료를 실시하였다. 환자 위치잡이의 재현성을 높이기 위하여 바로누운자세(supine)에서 환자고정용구(Extended Wing Board)를 사용하여 환자를 고정하였다. 획득한 영상은 치료계획시스템(Eclipse V10. Varian, USA)에서 CT, PET, 융합한 PET/CT에 GTV를 묘사하여 비교하였다. 결 과: 무기폐(atelectasis)나 폐렴(Pneumonitis)과 같은 합병증을 동반한 비소세포폐암 환자 5명에 대해 CT에 대한 PET의 GTV는 각각 10.5%, 11.8% 감소하였으나 67.9%, 220%, 19.4% 증가하였다. CT에 대한 PET/CT의 GTV는 각각 7.7%, 6.7%, 28% 감소하였으나 232%, 24%증가하였다. 결 론: FDG를 이용한 비소세포폐암 환자의 PET/CT 전산화 모의치료기는 GTV 묘사를 통하여 종양의 경계를 명확히 해주고 불확실한 표적체적을 정의하는데 CT보다 유용하여 앞으로 다른 부위에 추가 적용 가능할 것으로 보인다.

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