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Imagerie fonctionnelle et métabolique en radiothérapie

Functional and metabolic imaging in radiotherapy

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Oncologie

Résumé

Ces 15 dernières années ont vu le développement de la radiothérapie externe conformationnelle tridimensionnelle (RTC-3D) avec ou sans modulation d’intensité du faisceau d’irradiation, asservie ou non à la respiration et guidée par l’image. Cependant, l’un des prérequis fondamentaux pour effectuer une RTC-3D est de définin avec précision un volume tumoral macroscopique (VTM), un volume cible anatomoclinique ou microscopique (VCA) et un volume cible prévisionnel (VCP) prenant en compte les contraintes techniques de traitement. Bien que la simulation virtuelle par tomodensitométrie (TDM), malade en position de traitement, reste un standard pour l’acquisition des volumes cibles, l’imagerie fonctionnelle et métabolique apporte des informations complémentaires qui devraient contribuer à l’amélioration de la qualité de la RT. Elle comprend la tomographie par émission de positons (TEP), la tomographie par émission monophotonique (TESP), la spectroscopie de résonance magnétique (SRM) et l’IRM fonctionnelle (IRMf). De plus, ces techniques d’imagerie peuvent étre utilisées, à la fois, comme une aide décisionnelle pour la stratégie thérapeutique, comme un facteur prédictif de la réponse tumorale à la RT et comme un moyen d’évaluation de la réponse tumorale après RT.

Abstract

These past fifteen years have seen major developments in three-dimensional conformal radiotherapy (3D-CRT), with and without intensity-modulated, respiratorygated, or image-guided techniques. However, one of the fundamental prerequisites for 3D-CRT is the determination of gross tumour volume (GTV), clinical target volume (CTV), and planning target volume (PTV), always taking into account the limitations of the radiotherapy used. Although computed tomography (CT) in the treatment position remains the gold standard in radiotherapy planning, functional imaging — including positron emission topography (PET)/CT imaging, single photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS) and functional magnetic resonance imaging (f MRI) — provides complementary data and may contribute to improving treatment quality. Furthermore, functional imaging can be used as an aid in developing treatment strategy, as a predictive factor in tumour response, and as a tool to evaluate tumour response after RT.

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Authors and Affiliations

  1. Service d’Oncologie-Radiothérapie, hôpital Tenon, APHP, 4, rue de la Chine, F-75020, Paris, France

    E. Touboul, F. Huguet, O. -M. Cojocariu, A. Toledano, F. Deluen, S. Le Nagat, M. Rahmoun & J. -N. Foulquier

  2. Unité de Physique Médicale, service d’Oncologie-Radiothérapie, hôpital Tenon, APHP, 4, rue de la Chine, F-75020, Paris, France

    J. -N. Foulquier

  3. GHU-Est, université Pierre-et-Marie-Curie-Paris-VI, Paris, France

    E. Touboul, F. Huguet, O. -M. Cojocariu, A. Toledano, F. Deluen, S. Le Nagat, M. Rahmoun & J. -N. Foulquier

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  1. E. Touboul
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  2. F. Huguet
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  3. O. -M. Cojocariu
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Touboul, E., Huguet, F., Cojocariu, O.M. et al. Imagerie fonctionnelle et métabolique en radiothérapie. Oncologie 9, 451–457 (2007). https://doi.org/10.1007/s10269-007-0614-4

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  • DOI: https://doi.org/10.1007/s10269-007-0614-4

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