Application Of ¹⁸F-FDG SPECT/CT In Staging And Radiotherapy Of Lung Cancer

Objective:Analysis of 18-fluorodeoxyglucose single photon emission computered tomography imaging (18F-FDG SPECT/CT) in clinical stage of patients with newly diagnosed lung cancer, and compared with the CT-based clinical stage, To explore the 18F-FDG SPECT/CT scan effects in clinical stage and treatment strategies of patients with lung cancerMethods:55 cases confirmed by histopathology with lung cancer were retrospectively analysed, all patients come from Sir Run Run Shaw Hospital, Zhejiang University, from November 2007 to March 2009, All patients underwent 18 F-FDG SPECT/CT scan after the CT scan, positive finding of 18 F-FDG SPECT/CT scan were confirmed by MRI or CT scan.the clinical stage was performed after CT and 18 F-FDG SPECT/CT scan, and clinical stage after 18 F-FDG SPECT/CT scan was compared with CT-based. the effects of 18 F-FDG SPECT/CT scan in clinical stage and treatment strategies of patients with lung cancer were analysed.Results:In 55 patients,36 cases were males and 19 cases were females, Aged from 44 to 77 years old, median age was 62 years old. Of which 19 cases of adenocarcinoma,18 cases of squamous cell carcinoma,8 cases of small cell lung cancer,6 cases of bronchioloalveolar carcinoma,2 cases of adenosquamous carcinoma and undifferentia -ted carcinoma, separately. 18F-FDG SPECT/CT scan changed 13 patients (23.6%) in clinical stage, all phased upgrade, stageⅠb upgrade to stageⅡb, stageⅢa, stageⅢb of 1 case, separately, stageⅠb upgrade to stageⅣof 2 cases, stageⅡb upgrade stageⅢa, stageⅢb, stageⅣof 1 case, separately, stageⅢa upgrade to stageⅢb of 1 case, upgrade to stageⅣof 3 cases, stageⅢb upgrade to stageⅣof 1 case.9 casess (16.4%) treatment strategies were changed, from the radical operation into palliative radiotherapy or chemotherapy.after 18 F-FDG SPECT/CT scan stageⅣpatients increased, and there were significantly difference compared with CT-based clinical stage (χ2= 4.453, P= 0.035), there were no significantly difference between stageⅠ, stageⅡand stageⅢ(P>0.05)Conclusion:18F-FDG SPECT/CT scan changed the clinical stage and treatment strategies of partial lung cancer patients, 18 F-FDG SPECT/CT scan has important reference value of newly diagnosed lung cancer patients in clinical stage and treatment strategies. Objective:To explore 18-fluorodeoxyglucose single photon emission computered tomography imaging (18 F-FDG SPECT/CT) value in target delineation of three-dimensional conformal radiotherapy in non-small cell lung cancer(NSCLC)by comparing with the target delineation based on CT scan.Methods:3 NSCLC patients were selected from radiation oncology department, Sir Run Run Shaw hospita, Zhejiang university from June 2008 to March 2009,3 patients were confirmed adenocarcinoma by histopathology, CT and 18 F-FDG SPECT/CT scan were performed before delineation of gross tumor volume (GTV).the delineation of GTV according to the CT and 18 F-FDG SPECT/CT image, are named CT-GTV, SPECT-GTV, separately. the difference of CT-GTV and SPECT-GTV were compared in the three cases, and the reasons were analyzed.Results:Case 1, male, NSCLC patient with supraclavicular lymph node metastasis, CT-GTV was 100.86 cm3, SPECT-GTV was 98.67 cm3.Case 2, male, NSCLC patient with pulmonary atelectasis, CT-GTV was 239.59 cm3, SPECT-GTV was 117.08 cm3. Case 3, female, NSCLC patient with right supraclavicular lymph node metastasis, CT-GTV was 93.41 cm3, SPECT-GTV was 102.75 cm3.through coronal and sagittal images of GTV target, we found that the changs of GTV were through18 F-FDG SPECT /CT scan revealed a CT scan did not showed the metastatic lymph node and excluded lung atelectasis.Conclusion:18 F-FDG SPECT/CT scan changed the GTV of NSCLC patients by revealed a CT scan did not showed the metastatic lymph node and excluded lung atelectasis. improved the accuracy of target localization of three-dimensional conformal radiotherapy in NSCLC patients.