Impact of FDG‐PET on lung cancer delineation for radiotherapy

Abstract

The concordance of RO with the reference RO did not significantly increase with use of integrated FDG PET/CT images. However, the contouring of radiation oncology trainees' became more concordant with the reference.

Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

“…Although in our study the PS was not significantly related with the grading of RP, mainly due to the small number of patients, it should be mentioned that the concurrent chemo-radiotherapy should be under multidisciplinary evaluation in cases of poor PS (de Cos Escuín et al, 2007). At last but not least, the V20 associated with the radiological grading of RP is also significantly related with the optimization of target volumes in thoracic radiotherapy coming definitely from the implementation of PET-CT in the clinical practice (Morarji et al, 2012).…”

A review of interventions to reduce inter‐observer variability in volume delineation in radiation oncology

“…Interestingly, the participants in all these studies were qualified specialists including radiation oncologists, diagnostic radiologists and neurosurgeons. Conversely in all seven studies where the participants included trainees and/or radiation therapists, there was a significant reduction in IOV with additional or alternate imaging modalities …”

“…Some studies compared volume delineation on two separate imaging modalities including two different CT scans, CT vs MRI, CT vs cone‐beam CT and MRI scans using different sequences . Other studies compared standard imaging with the use of additional registered data sets such as specialised CT, MRI and PET . This refers to the importation of additional imaging as secondary data sets into the radiotherapy planning system and registration to the simulation CT usually using anatomical bony landmarks.…”

“…Delineation of volumes is a source of potential error in radiation therapy treatment. While many processes in radiotherapy planning and treatment can be automated towards millimetre accuracy this is not true for volume delineation where variation may be measured in centimetres . Correct volume delineation relies on a complex process of data assimilation.…”

Radiotherapy Planning

“…[54][55][56] Integrating PET/CT into radiotherapy planning can alter the target volumes when compared with CT-based volumes and also reduce interuser variability of target volume delineation. 57 In a prospective study of 91 consecutive patients, with non-small cell lung carcinoma from 2003 to 2008, undergoing radiation therapy, PET imaging provided additional diagnostic information over CT alone in 20%, leading to upstaging in 17% and alterations in the PTV and subsequent treatment planning in 9%. 58 PET/CT is particularly helpful in distinguishing tumor from lung atelectasis and subsequently reducing the GTV of the primary.…”