Fuzija PET/CT u planiranju radioterapije za karcinom pluća
Sažetak
Uvod. Primena visokorezolutivnih metoda snimanja, npr. kompjuterizovane tomografije (CT), magnetno-rezonantnog snimanja (MRI) I, poslednjih godina, pozitron-emisiona tomografija-kompjuterizovana tomografija (PET-CT), kao i konstrukcija efikasnih kompjuterskih sistema za planiranje radioterapije (TPS) omogućili su uvođenje koncepta virtuelne simulacije u planiranju 3D konformalne radioterapije (3D CRT). Prikaz bolesnika. U radu su prikazana dva bolesnika sa nemikroćelijskim karcinomom bronha kod kojih je načinjen PET/CT pregled. Oba bolesnika ranije su operisana a lokalni recidiv je otkriven primenom PET/CT pregleda. Nalazom PET/CT kod prvog bolesnika ustanovljeno je nakupljanje 18F-fluorodeoksiglakoze (18FDG), prečnika 2,9 × 2,9 × 2,1 cm u projekciji mekih tkiva u levom uglu u predelu operativnih klipseva. Opisana promena odgovarala je metabolički aktivnom recidivu tumora. Medijastinum i plućni parenhim desno bili su bez fokalne akumulacije 18FDG. Kod drugog bolesnika ustanovljen je fokus intenzivnog nakupljanja u regiji ožiljka apikalnog segmenta desnog plućnog krila promera 20 × 16 mm, koji je prevashodno odgovarao metabolički aktivnom recidivu tumora. U parenhimu pluća sa leve strane i na medijstinumu sa leve strane nije ustanovljeno prisustvo aktivnih fokusa. Radioterapijski tretman planiran je 3D konformalnom tehnikom pomoću fuzije PET/CT nalaza i CT za planiranje radioterapije. Zaključak. PET/CT obezbeđuje važne informacije za planiranje radioterapije, posebno za eskalaciju doze, poštede rizičnih organa i bolje lokoregionalne kontrole bolesti.
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