Application Value Of ¹¹C-CHO-PET/CT Imaging In Postoperative Radiotherapy Of High-grade Glioma

Objective To study the application of ¹¹C-CHO-PET/CT imaging in the determination of target range of postoperative radiotherapy for high-grade glioma,and to further explore the importance of biological target in postoperative radiotherapy for glioma.Methods Sixty patients with high-grade glioma diagnosed by craniotomy in the radiotherapy department of our hospital from January 2016 to January 2019 were collected.Among them,32 cases were used¹¹C-CHO-PET/CT images to guide the target area delineation,and 28 cases were used cranial location MRI/CT fusion images to delineate the target area.After the target area was perfected according to different image data,both groups received IMRT and oral temozolomide sensitization chemotherapy,followed by 6 cycles of temozolomide adjuvant chemotherapy 1 month after the end of treatment.The short-term efficacy,quality of life,adverse reactions and survival rate of patients in the two groups were analyzed and studied.The data obtained were processed by SPSS 26.0 software,and P<0.05 indicated statistically significant difference.Results（1）In the PET/CT group,21.88%（7/32）of the patients had ¹¹C-CHO-PET/CT imaging suggesting that increased uptake of ¹¹C-CHO around the operative area led to the expansion of GTVtb range compared with the corresponding MRI.（2）Evaluation of efficacy 3 months after treatment:the effective rate and disease control rate in PET/CT group were68.75%and 81.25%,which were significantly higher than42.86%and 57.14%in MRI group,and the differences were statistically significant（all P<0.05）.（3）During the treatment,adverse reactions related to radiotherapy and chemotherapy occurred in both groups,which were relieved after symptomatic treatment such as reducing cranial pressure and stopping emetic and protecting the stomach,without any serious adverse reactions.There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.（4）After 3 months of treatment,the quality of life after treatment in both groups was improved compared with that before treatment,and the difference was statistically significant（P<0.001）.Compared with the MRI group,the KPS score of the PET/CT group increased significantly and the difference was statistically significant（P<0.05）.（5）Followed up for 2 years,the data were analyzed and the survival curves of the two groups were drawn.According to the curves,the median survival time of the PET/CT group was 22.3 months,significantly higher than that of the MRI group（16.3 months）,and the difference was statistically significant（P<0.05）.Conclusion（1）Compared with traditional MRI,¹¹C-CHO-PET/CT imaging can better judge the residual tumor after HGG based on the aggregation concentration of ¹¹C-CHO.（2）¹¹C-CHO-PET/CT imaging suggested residual HGG lesions can guide clinicians to draw more accurate biological target volume,which can more accurately define the biological target area than traditional MRI.（3）The local control rate and quality of life of HGG tumor can be effectively improved and survival time can be prolonged in patients treated by biological target therapy.（4）¹¹C-CHO-PET/CT imaging has important clinical application value in the target location of postoperative radiotherapy for HGG.