Can 18-FDG-PET During Radiotherapy Replace Post-Therapy Scanning for Detection/Demonstration of Tumor Response in Head-and-Neck Cancer?

Ceulemans, G; Voordeckers, Mia; Farrag, Ashraf; Verdries, D; Storme, Guy; Everaert, Hendrik

doi:10.1016/j.ijrobp.2010.07.019

Cited by 46 publications

(27 citation statements)

References 23 publications

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“…Reports on using 18 F-FDG for early response assessment during radiotherapy or chemoradiotherapy are much less frequent than reports on late 18 F-FDG PET/CT-based response assessment. Generally, reports on early assessment agree that 18 F-FDG PET/CT during chemoradiotherapy may help differentiate responders from nonresponders, but these results are not yet reliable enough to replace posttherapy 18 F-FDG PET/CT evaluation (90).…”

Section: Prognostic Role Of Molecular Imaging In Radiation Therapymentioning

confidence: 99%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) how to acquire high-quality molecular images for use in radiation therapy; (2) how molecular imaging can be used to plan radiotherapy and evaluate treatment efficacy; and (3) the limitations and challenges to widespread use of molecular imaging in radiation oncology.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through November 2018.Molecular imaging plays a central role in the management of radiation oncology patients. Specific uses of imaging, particularly to plan radiotherapy and assess its efficacy, require an additional level of reproducibility and image quality beyond what is required for diagnostic imaging. Specific requirements include proper patient preparation, adequate technologist training, careful imaging protocol design, reliable scanner technology, reproducible software algorithms, and reliable data analysis methods. As uncertainty in target definition is arguably the greatest challenge facing radiation oncology, the greatest impact that molecular imaging can have may be in the reduction of interobserver variability in target volume delineation and in providing greater conformity between target volume boundaries and true tumor boundaries. Several automatic and semiautomatic contouring methods based on molecular imaging are available but still need sufficient validation to be widely adopted. Biologically conformal radiotherapy (dose painting) based on molecular imaging-assessed tumor heterogeneity is being investigated, but many challenges remain to fully exploring its potential. Molecular imaging also plays increasingly important roles in both early (during treatment) and late (after treatment) response assessment as both a predictive and a prognostic tool. Because of potentially confounding effects of radiation-induced inflammation, treatment response assessment requires careful interpretation. Although molecular imaging is already strongly embedded in radiotherapy, the path to widespread and all-inclusive use is still long. The lack of solid clinical evidence is the main impediment to broader use. Recommendations for practicing physicians are still rather scarce. 18 F-FDG PET/CT remains the main molecular imaging modality in radiation oncology applications. Although other molecular imaging options (e.g., proliferation imaging) are becoming more common, their widespread use is limited ...

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Section: Prognostic Role Of Molecular Imaging In Radiation Therapymentioning

confidence: 99%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

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“…Radyoterapi sonrası değerlendirme amaçlı PET/CT çekimi için en uygun zaman tedavi sonrası 2-3. aydır (26) . Tedavi sonrası 3. ayda yapılan PET/CT nin daha erken zamanlı görüntülemelere göre daha doğru sonuç verdiği gösterilmiştir (27,28) . Nüks tümör varlığını tespit etmek de tıpkı rezidü tümör tespiti gibi zordur (29,30) .…”

Section: Tedavi Sonrası Değerlendirmeunclassified

Role of Positron Emission Tomography in Head and Neck Tumors

Aydoğdu¹,

Saltürk²,

Yıldırım³

et al. 2015

Okmeydani Medical Journal

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“…Imaging at 10-20 Gy (1-2 wk into radiation therapy) was found to be the best time point for using 18 F-FDG PET to monitor patients during therapy (5). The performance of 18 F-FDG PET was, however, significantly lower in predicting disease-free survival in 2 additional studies when 18 F-FDG PET was performed later, after 40 or 47 Gy of radiation, and images were analyzed only visually for the presence or absence of residual uptake in tumors (6,7). It has also been questioned whether the changes in standardized uptake value (SUV) early after radiation therapy fully reflect the changes in the biology of head and neck cancer.…”

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confidence: 99%