The impact of PET/CT scanning on the size of target volumes, radiation exposure of organs at risk, TCP and NTCP, in the radiotherapy planning of non-small cell lung cancer

Vojtíšek, Radovan; Mužı́k, Jan; Šlampa, Pavel; Budíková, Marie; Hejsek, Jaroslav; Smolak, Petr; Ferda, Jiří; Fínek, Jindřich

doi:10.1016/j.rpor.2013.09.006

Cited by 11 publications

(6 citation statements)

References 38 publications

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“…The current clinical applications of PET in oncology include diagnosis and staging. Despite PET images have lower spatial resolution, it has the potential to further improve target delineation when registered with CT or MRI images and some positive results of PET in tumours of the thoracic region have been reported [ 10 – 12 ]. For target delineation of head and neck cancers, the benefit of PET is still controversial [ 7 , 13 ], especially when this modality introduces radiation dose to staff and is relatively more expensive.…”

Section: Introductionmentioning

confidence: 99%

The impact of positron emission tomography on primary tumour delineation and dosimetric outcome in intensity modulated radiotherapy of early T-stage nasopharyngeal carcinoma

Leung

Wong

et al. 2016

Radiat Oncol

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BackgroundIn intensity modulated radiotherapy (IMRT) of nasopharyngeal carcinoma (NPC), accurate delineation of the gross tumour volume (GTV) is important. Image registration of CT and MRI has been routinely used in treatment planning. With recent development of positron emission tomography (PET), the aims of this study were to evaluate the impact of PET on GTV delineation and dosimetric outcome in IMRT of early stage NPC patients.MethodsTwenty NPC patients with T1 or T2 disease treated by IMRT were recruited. For each patient, 2 sets of NP GTVs were delineated separately, in which one set was performed using CT and MRI registration only (GTVCM), while the other set was carried out using PET, CT and MRI information (GTVCMP). A 9-field IMRT plan was computed based on the target volumes generated from CT and MRI (PTVCM). To assess the geometric difference between the GTVCM and GTVCMP, GTV volumes and DICE similarity coefficient (DSC), which measured the geometrical similarity between the two GTVs, were recorded. To evaluate the dosimetric impact, the Dmax, Dmin, Dmean and D95 of PTVs were obtained from their dose volume histograms generated by the treatment planning system.ResultsThe overall mean volume of GTVCMP was greater than GTVCM by 4.4 %, in which GTVCMP was slightly greater in the T1 group but lower in the T2 group. The mean DSC of the whole group was 0.79 ± 0.05. Similar mean DSC values were also obtained from the T1 and T2 groups separately. The dosimetric parameters of PTVCM fulfilled the planning requirements. When applying this plan to the PTVCMP, the average Dmin (56.9 Gy) and D95 (68.6 Gy) of PTVCMP failed to meet the dose requirements and demonstrated significant differences from the PTVCM (p = 0.001 and 0.016 respectively), whereas the doses to GTVCMP did not show significant difference with the GTVCM.ConclusionIn IMRT of early stage NPC, PET was an important imaging modality in radiotherapy planning so as to avoid underdosing the PTV, although its effect on GTV delineation was not significant. It was recommended that PET images should be included in the treatment planning of NPC patients.

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Section: Introductionmentioning

confidence: 99%

The impact of positron emission tomography on primary tumour delineation and dosimetric outcome in intensity modulated radiotherapy of early T-stage nasopharyngeal carcinoma

Leung

Wong

et al. 2016

Radiat Oncol

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“…Many studies show that when PET is used, radiotherapy fields or target volumes or estimates of GTV are different from the treatment fields or volumes that would have been drawn if PET had been unavailable 11,16,17 .…”

Section: Discussionmentioning

confidence: 99%

PET/CT fusion in radiotherapy planning for lung cancer - case reports

et al. 2016

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“…Conforme os dados obtidos, apenas 43% dos volumes tumorais foram corretamente delineados pelos valores de GTV CT e PTV CT. Ainda, estes pesquisadores demonstraram que em 80% dos pacientes, o planejamento radioterápico baseado apenas no PTV CT não cobre o volume de tratamento estabelecido pela PET-CT. Em um estudo semelhante, Leclerc et al 56 mostram que o volume alvo da radioterapia foi significativamente reduzido na PET-CT/ 18 FDG comparado aquele da tomografia computadorizada em pacientes com câncer de orofaringe, resultando em diminuição da dose de radiação na parótida e cavidade bucal. Quando analisados os dados de GTV PET-CT e PTV PET-CT em pacientes com câncer de pulmão, Vojtísek et al 57 revelaram que a incorporação destes dois parâmetros reduz significativamente a exposição do esôfago, medula espinhal e coração ao tratamento radioterápico, diminuindo a probabilidade de complicações do tecido saudável.…”

Section: Pet-ct/ 18 F-fdg No Planejamento Do Tratamento De Radioterapiaunclassified

Princípios básicos e aplicações oncológicas da PET-CT/18F-FDG

Dias

Carvalho

Pereira

2020

Rev. Med. (São Paulo)

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A Tomografia por Emissão de Pósitrons/Tomografia Computadorizada representa um grande salto tecnológico para a Medicina Nuclear e particularmente, para a Oncologia, visto que é capaz de distinguir alterações benignas e malignas com base em dados semiquantitativos da metabolização de radiofármacos pelos tecidos corporais. Este trabalho teve como objetivo realizar uma revisão narrativa dos principais levantamentos bibliográficos contemporâneos acerca dos princípios físicos da PET-CT/18F-FDG, suas aplicações na Oncologia e os avanços tecnológicos desta metodologia. Este trabalho foi elaborado com base em artigos obtidos de bancos de dados como PubMed, SciELO e Microsoft Academic Search, com descritores relacionados a PET-CT/18F-FDG e a Oncologia. A partir dos artigos analisados, observa-se que a PET-CT/18F-FDG é uma importante técnica para a obtenção de imagens morfofuncionais do corpo do paciente com sensibilidade e especificidade, muitas vezes, superiores aos métodos convencionais de diagnóstico por imagem. Dessa forma, a PET-CT/18F-FDG é recomendada nos casos de identificação e acompanhamento do estadiamento tumoral, monitoramento da taxa de resposta das terapias oncológicas e planejamento do alvo em tratamentos radioterápicos. Ainda, o desenvolvimento de algoritmos matemáticos e de sistemas de detecção de radiação mais eficientes na PET-CT/18F-FDG melhoram a qualidade da imagem e reduzem o tempo de exame.

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The impact of PET/CT scanning on the size of target volumes, radiation exposure of organs at risk, TCP and NTCP, in the radiotherapy planning of non-small cell lung cancer

Abstract: Conclusions: Our study found that the use of planning PET/CT in the radiotherapy planning of NSCLC has a crucial impact on the precise determination of target volumes, more precise staging of the disease and thus also on possible changes of treatment strategy.

Cited by 11 publications

References 38 publications

The impact of positron emission tomography on primary tumour delineation and dosimetric outcome in intensity modulated radiotherapy of early T-stage nasopharyngeal carcinoma

The impact of positron emission tomography on primary tumour delineation and dosimetric outcome in intensity modulated radiotherapy of early T-stage nasopharyngeal carcinoma

PET/CT fusion in radiotherapy planning for lung cancer - case reports

Princípios básicos e aplicações oncológicas da PET-CT/18F-FDG

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