The application of positron emission tomography/computed tomography in radiation treatment planning: effect on gross target volume definition and treatment management.
Clin Oncol (R Coll Radiol)
; 22(3): 173-8, 2010 Apr.
Article
em En
| MEDLINE
| ID: mdl-20116979
ABSTRACT
AIMS:
To analyse the effect of the use of molecular imaging on gross target volume (GTV) definition and treatment management. MATERIALS ANDMETHODS:
Fifty patients with various solid tumours who underwent positron emission tomography (PET)/computed tomography (CT) simulation for radiotherapy planning from 2006 to 2008 were enrolled in this study. First, F-18 fluorodeoxyglucose (FDG)-PET and CT scans of the treatment site in the treatment position and then a whole body scan were carried out with a dedicated PET/CT scanner and fused thereafter. FDG-avid primary tumour and lymph nodes were included into the GTV. A multidisciplinary team defined the target volume, and contouring was carried out by a radiation oncologist using visual methods. To compare the PET/CT-based volumes with CT-based volumes, contours were drawn on CT-only data with the help of site-specific radiologists who were blind to the PET/CT results after a median time of 7 months.RESULTS:
In general, our PET/CT volumes were larger than our CT-based volumes. This difference was significant in patients with head and neck cancers. Major changes (> or =25%) in GTV delineation were observed in 44% of patients. In 16% of cases, PET/CT detected incidental second primaries and metastatic disease, changing the treatment strategy from curative to palliative.CONCLUSIONS:
Integrating functional imaging with FDG-PET/CT into the radiotherapy planning process resulted in major changes in a significant proportion of our patients. An interdisciplinary approach between imaging and radiation oncology departments is essential in defining the target volumes.
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Base de dados:
MEDLINE
Assunto principal:
Planejamento da Radioterapia Assistida por Computador
/
Tomografia Computadorizada por Raios X
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Tomografia por Emissão de Pósitrons
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Neoplasias
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article