功能影像学技术在头颈部肿瘤放疗计划制定、疗效评估和个体化治疗中的应用课件.pptxVIP

Functional Imaging for Radiation Treatment Planning, Response Assessment, and Adaptive Therapy in Head and Neck Cancer福建省肿瘤医院郑德春 博士Role of routine and functional Imaging (FI)Screening and diagnosis of neoplasmsPrecise staging of malignancyResponse assessment of cancer treatmentMonitor recurrencesBenefit of FIMajor modalities of FI:positron emission tomography (PET) combined with CT or magnetic resonance (MR) imagingfMRI: DWI, DCE-MRI, BOLD, spectroscopy etc.Emerging techniques: PET-MRI, DKI, IVIM, APT, CEST etc.Offer complementary information including metabolism of FDG, proliferation, hypoxia, and cell membrane synthesis by PEThypoxia and permeability by DCE MRI and IVIM, cell proliferation and apoptosis by DWI, IVIM and DKI, and epidermal growth factor receptor status.About this articlePart I: Discusses the practical aspects of integrating functional imaging into head-and-neck radiation therapy planning. Part II: Reviews the potential of molecular imaging biomarkers for response assessment and therapy adaptation. Authors concluded that FI allowed more individualized treatment planning in patients with head and neck SCCs in the emerging era of personalized medicine.Part I Role of Functional Imaging in Radiation Therapy PlanningThere was a 20% decrease in OS among patients who underwent radiation therapy with a protocol that did not comply with established institutional standards. Reasons: Inaccuracies in tumor target delineation Inter-observer variability in clinical practice based on CT for target delineationFunctional MRI and PET techniques provide different and potentially complementary information about the tumor extent and biologic activity.PET-based Tumor Target ContouringTumor uptake of PET radioactive tracers can provide excellent contrast resolution between neoplastic and normal tissues. There are two DOSE CONTOURING methods: visual interpretation and automated delineation methods.Example of automated delineationFigure 2. SCC arising from the epiglottis