目的：此研究的目的在評估治療後做氟-18去氧葡萄糖正子斷層攝影，是否能預測神經膠質瘤病人對加馬刀放射手術的治療反應。方法：此研究包括18位經組織學證實有神經膠質瘤以加馬刀放射手術治療並追蹤超過24個月的病人。所有的病人都在加馬刀放射手術治療後的6-8個月實施氟-18去氧葡萄糖正子斷層攝影。結合正子斷層攝影和磁振造影的影像測量腫瘤對皮質(T/C)與腫瘤對白質(T/WM)氧-18去氧葡萄糖的攝取率。用加強顯影的磁振造影測量腫瘤最大直徑的變化（最後一次追蹤的磁振造影比較加馬刀放射手術治療前的磁振造影），腫瘤反應依等級分完全緩解(CR)，部分緩解(PR)，疾病穩定(SD)和疾病惡化(PD)。第一組包含4例部分緩解的腫瘤和6例疾病穩定的腫瘤，第二組包含8例做完加馬刀放射手術治療疾病惡化的腫瘤。結果：第一組病人的平均腫瘤對皮質(T/C)與腫瘤對白質(T/WM)氟-18去氧葡萄糖的攝取率比第二組病人呈有意義的減少。結論：我們的研究顯示對經過加馬刀放射手術治療的神經膠質瘤的病人而言，治療後的氟-18去氧葡萄糖正子斷層攝影可以用來預測治療效果。
Purpose: To evaluate whether post-treatment fluorodeoxyglucose-positron emission tomography can predict the response to gamma knife surgery (GKS) for patients with gliomas. Method: Eighteen patients with histologically confirmed gliomas treated by GKS and followed for more than 24 months were recruited. All patients underwent fluorodeoxyglucose positron emission tomography 6 to 8 months after GKS. Positron emission tomographic images and MR images were fused, and tumor-to-cortex (TIC) and tumor-to-white matter (TIWM) fluorodeoxyglucose uptake ratios were measured. By estimating and comparing the change of the maximum tumor diameter measured on the contrast-enhanced MRI (the last follow-up MRI vs. the pre-GKS MRI), we could classify tumors into complete remission (CR), partial remission (PR), stable disease (SD), and progression of disease (PD). Group I had four tumors with PR and 6 tumors with SD, and Group II had 8 tumors with PD after GKS. Results: Both mean TIC ratio and mean TIWM ratio of Group I patients are statistically less than those of Group II patients. Conclusion: Our study suggests that, for patients with gliomas treated by GKS, the post-treatment fluorodeoxyglucose-positron emission tomography could be used to predict response to treatment.
