Comparison of CT and integrated PET-CT based radiation therapy planning in patients with malignant pleural mesothelioma

Pehlivan, Berrin; Topkan, Erkan; Onal, Cem; Nursal, Gül Nihal; Yuksel, Oznur; Dolek, Yemliha; Yavuz, Mustafa; Yavuz, Ali Aydın

doi:10.1186/1748-717x-4-35

Cited by 26 publications

(6 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PET/CT is the current imaging modality of choice for mesothelioma staging, prognosis and early therapeutic response assessment, highlighting tumour metabolism to differentiate malignant from benign lesions, identifying occult metastases and in radiotherapy planning, minimising geographical misses and reducing target volumes by excluding regions of fibrosis from viable tumour. 12,33,34 In a comparison of the four modalities for preoperative staging, integrated PET/CT scanning had superior accuracy and reduced interobserver variability than CT and PET alone, and MRI scanning. 35 We have had no serious toxicities from our programme, and only three patients have required short-term steroids for radiation pneumonitis.…”

Section: Discussionmentioning

confidence: 99%

Establishing locoregional control of malignant pleural mesothelioma using high-dose radiotherapy and 18F-FDG PET/CT scan correlation

Feigen

Lee

Lawford

et al. 2011

Journal of Medical Imaging and Radiation Oncology

View full text Add to dashboard Cite

We have established that mesothelioma can be locally controlled with high radiation doses using 3DCRT or IMRT, and that strict normal tissue dose constraints have limited radiation toxicities. Radiotherapy should be considered to prevent or delay the local manifestations of progressive disease in suitable patients after surgery including extrapleural pneumonectomy and pleurectomy/decortication. Higher radiation doses may allow more effective palliation.

show abstract

Section: Discussionmentioning

confidence: 99%

Establishing locoregional control of malignant pleural mesothelioma using high-dose radiotherapy and 18F-FDG PET/CT scan correlation

Feigen

Lee

Lawford

et al. 2011

Journal of Medical Imaging and Radiation Oncology

View full text Add to dashboard Cite

show abstract

“…Seven patients with unresectable MPM who underwent positron emission tomography-computerized tomography (PET-CT) imaging in the supine position with both arms raised over their heads utilizing the T-bar to mimic set-up conditions were selected. e PET-CT scans were performed in an integrated PET-CT system (Discovery-STE 8, General Electric Medical Systems, Milwaukee, WI, USA) using a previously published imaging procedure [12]. PET-CT data sets were transferred to a treatment planning system (Eclipse 10.0, Varian Medical Systems, Palo Alto, CA, USA) and HT HI-ART2 in the DICOM format.…”

Section: Methodsmentioning

confidence: 99%

Dosimetric Comparison of Lung-Sparing Radiation Therapy between Volumetric Arc Therapy and Helical Tomotherapy for Unresectable Malignant Pleural Mesothelioma

Pehlivan

Sengul

Yeşil

et al. 2019

BioMed Research International

Self Cite

View full text Add to dashboard Cite

Objective. To compare volumetric arc therapy (VMAT) and helical tomotherapy (HT) plans in terms of dosimetric parameters in positron emission tomography- (PET-) computerized tomography- (CT-) based radiation therapy planning in unresectable malignant pleural mesothelioma (MPM). Methods. CT and coregistered PET-CT data from seven patients with histologically-proven MPM were utilized for VMAT and HT plans. Target volumes and organs at risk (OARs) were delineated. The prescription doses for planning target volume 1 (PTV1) and PTV2 were 45.0 Gy and 54 Gy in 1.8 Gy/fr, respectively. Each technique was evaluated in terms of target volume coverage and OAR doses. Findings. Although the maximum (p=0.001) and mean (p<0.001) doses of PTV1, and PTV2 (p<0.001 for maximum and p=0.001 for mean doses) favored the HT technique over VMAT, both techniques efficiently covered the target volumes. Additionally, HT also provided more homogeneous dose distribution (p<0.001) and numerically lower doses received by most OARs, but again both rotational techniques were successful in keeping the OAR doses below the universally accepted limits. The major disadvantage of the HT technique was the requirement for longer treatment times (7.4 versus 2.5 minutes/fr; p<0.001) to accomplish the intended treatment. Conclusion. Results of this dosimetric comparison clearly demonstrated the possibility of safe hemithoracic irradiation of medically/technically unresectable MPM patients with either of the two rotational RT techniques, namely the VMAT and HT. Clinically, considering their poor prognosis, these promising findings may open a potential new window for curative treatment of unresectable MPM patients, if further confirmed by future clinical studies.

show abstract

“…In order to compare CT with PET/CT as the basis for delineating target volumes in these patients, Pehlivan et al [39] retrospectively evaluated data from these two approaches in 13 patients with histologically proven MPM. For each patient, target volumes [gross tumor volume (GTV), clinical target volume (CTV), and planning target volume (PTV)] were defined using the required data sets.…”

Section: Pet/ct For Rt Planning In Mpmmentioning

confidence: 99%

Current Evidence Base of FDG-PET/CT Imaging in the Clinical Management of Malignant Pleural Mesothelioma: Emerging Significance of Image Segmentation and Global Disease Assessment

et al. 2010

View full text Add to dashboard Cite

Increasingly, integrated positron emission tomography-computed tomography (PET/CT) imaging is playing a crucial role in the assessment of patients with known or suspected malignant pleural mesothelioma (MPM). Based on the data reported in the literature, this combined modality is likely to become the instrument of choice for examining patients of MPM. The research on this subject has focused on the following five domains: (1) differentiation of MPM from other benign pleural diseases, (2) preoperative staging for the selection of appropriate candidates for surgery, (3) evaluation for therapy response and post-treatment surveillance for recurrence, (4) prognostication based upon the intensity of 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) uptake, and (5) planning of radiotherapy. These represent the bases for critical decision making in the management of mesothelioma, and FDG-PET/CT offers potential advantages over conventional CT imaging and thus can play a pivotal role in this regard. Optimal characterization of this potentially fatal disease with a high negative predictive value for MPM, superior capability for cancer staging initially and at the later course of disease, and ability for measuring therapeutic response and the precise determination of the target volume for radiotherapy planning represent distinct advantages of this promising molecular imaging tool. In this communication, we have explored the promising role of integrated FDG-PET/CT in the overall management of this serious malignancy. From the available data, the major role of PET-CT at present appears to be in the preoperative disease staging, response to treatment assessment, and post-treatment disease surveillance of MPM. In all these three areas, PET-CT convincingly shows better results than conventional anatomical imaging alone and thereby can aid in exploring novel therapeutic approaches. Disease prognosis and radiotherapy planning are evolving areas where this modality has demonstrated significant promise, but this has to be investigated further. The differentiating of MPM from benign pleural disease is a challenging issue; though in limited studies, it has shown promising results, single standardized uptake value (SUV) cutoff technique cannot be the optimal way for this purpose. Dual time point and delayed imaging helps further in this setting; however, more data require to be accrued in this area. We, in this review, have also discussed the feasibility of a new method of image segmentation based on an iterative thresholding algorithm, which permits definition of the boundaries of lesions based on PET images alone to provide lesional metabolically active tumor volumes, lesional partial volume corrected SUV (PVC-SUV) measurements, lesional PVC metabolic burden (PVC-MB) (calculated as the product of lesional MVP and lesional PVC-SUV), and whole body metabolic burden (WBMB) (calculated as the sum of lesional PVC-MB of all lesions). This global disease assessment, we believe, will be the way forward for assessing this malignancy with a non-invasive...

show abstract

Comparison of CT and integrated PET-CT based radiation therapy planning in patients with malignant pleural mesothelioma

Cited by 26 publications

References 36 publications

Establishing locoregional control of malignant pleural mesothelioma using high-dose radiotherapy and 18F-FDG PET/CT scan correlation

Establishing locoregional control of malignant pleural mesothelioma using high-dose radiotherapy and 18F-FDG PET/CT scan correlation

Dosimetric Comparison of Lung-Sparing Radiation Therapy between Volumetric Arc Therapy and Helical Tomotherapy for Unresectable Malignant Pleural Mesothelioma

Current Evidence Base of FDG-PET/CT Imaging in the Clinical Management of Malignant Pleural Mesothelioma: Emerging Significance of Image Segmentation and Global Disease Assessment

Contact Info

Product

Resources

About