PET scans in radiotherapy planning of lung cancer

Ruysscher, Dirk De; Nestle, Ursula; Jeraj, Robert; MacManus, Michael

doi:10.1016/j.lungcan.2011.07.018

Cited by 82 publications

(43 citation statements)

References 39 publications

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“…A series of review papers has been published on PET for radiation treatment planning for various tumor sites, including the brain (50), head and neck (51), lung (52), gastrointestinal tract (53), prostate (54), and cervix/ endometrium (55). For some situations, such as mediastinal lymph node staging for lung cancer, the sensitivity of 18 F-FDG PET/CT appears to be superior to CT alone at detecting involved lymph nodes (52). In others, such as colorectal cancer, PET does not perform as well (56).…”

Section: Nodal Involvementmentioning

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: Nodal Involvementmentioning

confidence: 99%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

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“…Because numerous studies have shown the potential of 18 F-FDG PET for staging, delineating target volume, assessing response, and detecting relapse in a wide variety of cancers, along with the associated impact on management of patients, it has become the cornerstone of biologic imaging in oncology (1,2). Although increased metabolism due to the Warburg effect is an important reflection of tumor aggressiveness, more specific tracers to depict distinct tumor characteristics have been developed.…”

Section: Functional and Molecular Imaging Modalities Currently Availablementioning

confidence: 99%

Imaging-Based Treatment Adaptation in Radiation Oncology

2015

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Learning Objectives: On successful completion of this activity, participants should be able to (1) understand the clinical implications of tumor characterization using different PET tracers before and during radiotherapy or chemoradiotherapy; (2) discuss the role of other functional imaging modalities (CT and MRI) in current oncology practice; and (3) introduce additional applications of PET imaging, such as in high-energy proton-beam therapy.

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“…18 F-FDG PET/(CT) information in radiotherapy planning allows better target volume definition, reduces inter-observer variability and encourages selective irradiation of involved mediastinal lymph nodes (7). Thus, the use of PET and PET/CT images for radiation treatment planning has become widespread (8).…”

Section: Introductionmentioning

confidence: 99%

A Clinical Study of Shrinking Field Radiation Therapy Based on ¹⁸F-FDG PET/CT for Stage III Non-Small Cell Lung Cancer

Ding

Wang

et al. 2013

Technol Cancer Res Treat

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The aim is to investigate the feasibility of shrinking field technique after 40 Gy for stage III nonsmall cell lung cancer (NSCLC) during radiation therapy. Eighty-seven consecutive patients treated with intensity-modulated radiation therapy or three-dimensional conformal radiation therapy were enrolled in this study. months, ranging from 5 to 46 months, and the 1-and 2-year overall survival rates in our study were 74.7% and 34.6%. The response rate was 79.5%, and radiation toxicity was acceptable. Tumor progression occurred in 67.8% (59/87) patients. Numbers of patients who had outfield, infield and both infield and outfield recurrences were 3 (3.4%), 26 (29.5%), and 3 (3.4%), respectively. In conclusion, significant tumor regression was observed after 40 Gy, and radiation dose escalated after shrinking field with acceptable toxicity and outfield relapse. Shrinking field radiotherapy based on 18 F-FDG PET/CT after 40 Gy was safe and feasible for stage III NSCLC.

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PET scans in radiotherapy planning of lung cancer

Cited by 82 publications

References 39 publications

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

Imaging-Based Treatment Adaptation in Radiation Oncology

A Clinical Study of Shrinking Field Radiation Therapy Based on ¹⁸F-FDG PET/CT for Stage III Non-Small Cell Lung Cancer

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PET scans in radiotherapy planning of lung cancer

Cited by 82 publications

References 39 publications

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

Imaging-Based Treatment Adaptation in Radiation Oncology

A Clinical Study of Shrinking Field Radiation Therapy Based on 18F-FDG PET/CT for Stage III Non-Small Cell Lung Cancer

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A Clinical Study of Shrinking Field Radiation Therapy Based on ¹⁸F-FDG PET/CT for Stage III Non-Small Cell Lung Cancer