2013-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/655246摘要：背景：肺癌是世界上最重要的腫瘤死亡原因，早期偵測肺癌並治療早期肺癌對於增加病患之存活，十分重要。早期肺癌能夠接受外科手術治療，但大多數之肺癌被發現時均為晚期；因此，化學治療與放射線治療對於這些晚期肺癌十分重要。最近之研究顯示，在決定病患與腫瘤特性之後，可以採取個人化治療方式之選擇，本三年研究計畫為針對早期與擴展期病患發展動態灌流電腦斷層檢查定量與分析之系統。目的：發展針對早期與擴展期非小細胞肺癌電腦斷層型態與定量灌流檢查之評估系統，並藉以評估使用電腦斷層灌流檢查在腫瘤特性分析之臨床重要性。材料與方法：在第一年，我們將發展電腦斷層檢查之影像分析平台，並克服技術困難，以增加其正確率。此外，我們將納入可接受外科手術之非小細胞肺癌病患，接受術前電腦斷層灌流檢查，藉以瞭解腫瘤特性並對照病理組織學結果。在第二年中，我們將分析有確實診斷之肺臟結節之三維型態特性，並發展程式來分析腫瘤型態與灌流特性參數。擴展期之肺癌病患亦將被納入來評估化學治療前後之系列電腦斷層灌流檢查。在第三年中，我們將發展預測放射線治療後肺臟實質變化之技術，擴展期之肺癌病患需接受放射線治療、同步放射線化學治療或高劑量放射線治療者將被納入，以瞭解腫瘤治療反應與機制。在本研究計畫中，我們將經由跨領域之團隊合作，來評估早期與擴展期肺癌之電腦斷層灌流特性。我們相信，發展電腦斷層灌流檢查之程式與技術，有助於依照個人特性來增加瞭解肺癌治療與監測肺癌治療結果，並可瞭解可能之預測性與預後性影像生物標記（Imaging biomarker）。<br> Abstract: BackgroundLung cancer is the leading cause of cancer mortality worldwide. Early detection of lung cancer and treating lung cancer in early stage are important to increase patient survival. Early lung cancer can be treated with surgical intervention. However, most of the lung cancers are found in late stage. Therefore, chemotherapy and radiotherapy are extremely important to treat these advanced lung cancer. Recent advance shows the potential to allow individualized selection of the treatment as determined by the characteristic of the patients and tumors. This is a 3‐year proposal for developing a system for quantification and characterization of dynamic perfusion computed tomography (CT) in patients with lung cancer in early stage and advanced stage.Purpose: To develop a system for CT morphology and quantitative perfusion study of patients with early and advanced stage non‐small cell lung cancer (NSCLC) and to evaluate the clinical importance of CT tumor characterization using perfusion CT technique.Materials and methodsIn the first year, we will develop the imaging analyzing platform for CT perfusion study and overcome the technical problem to increase accuracy. In addition, we will enroll surgical candidates of NSCLC for preoperative perfusion CT study to understand tumor characterization with correlation to histopathologic results. In the second year, we will analyze 3D morphologic characters of lung nodules with definite diagnosis, and develop programs for analyzing tumor morphology and perfusion parameters. Lung cancer patients with advanced stage will be enrolled to evaluate serial perfusion CT studies before and after the course of chemotherapy. In the third year, we will develop the technique to predict lung parenchymal change following radiotherapy. Patients with advanced lung cancer receiving radiotherapy or concurrent chemoradiotherapy or high‐dose radiotherapy will be enrolled to understand the mechanism of tumor response.SummaryIn this proposal, CT perfusion study through multidisciplinary collaboration to characterize early and advanced lung cancer will be performed. We believe it is very important to develop this program and technique for CT perfusion which might be able to increase additional information of treating and following up lung cancer patients according to individualized difference and to understand possible predictive and prognostic imaging biomarkers.肺癌電腦斷層電腦輔助血液灌流lung cancercomputed tomographycomputer assistanceperfusion