ABSTRACT
This study investigated the usefulness of [18F]-3'-deoxy-3'-fluorothymidine (18F-FLT) and [18F]-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) imaging for predicting the therapeutic efficacy of non-small cell lung cancer (NSCLC) irradiation at an early stage after radiation treatment. Mice were xenografted with the human lung adenocarcinoma line A549 or large cell lung cancer line FT821. Tumour uptake of 18F-FLT and 18F-FDG was imaged using PET/CT before and 1 week after irradiation. In A549 tumours, 18F-FLT uptake was significantly decreased, and 18F-FDG uptake was unchanged post-irradiation compared with pre-irradiation. In FT821 tumours, uptake of both 18F-FLT and 18F-FDG uptake was substantially decreased post-irradiation compared with pre-irradiation. In both xenografts, tumour volumes in the irradiated groups were significantly decreased compared with those in the control group. 18F-FLT is expected to contribute to individual NSCLC therapy because it accurately evaluates the decrease in tumour activity that cannot be captured by 18F-FDG. 18F-FDG may be useful for evaluating surviving cells without being affected by the inflammatory reaction at an extremely early stage, approximately 1 week after irradiation. Combined use of 18F-FLT and 18F-FDG PET/CT imaging may increase the accurate prediction of radiotherapy efficacy, which may lead to improved patient outcomes and minimally invasive personalised therapy. J. Med. Invest. 70 : 361-368, August, 2023.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Humans , Mice , Animals , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/radiotherapy , Fluorodeoxyglucose F18/metabolism , Fluorodeoxyglucose F18/therapeutic use , Positron Emission Tomography Computed Tomography , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/radiotherapy , Lung Neoplasms/drug therapy , Radiopharmaceuticals/therapeutic use , Positron-Emission Tomography/methodsABSTRACT
PURPOSE: The purpose of this study was to assess the quality of treatment planning using the PlanIQTM software and to investigate whether it is possible to improve the quality of treatment planning using the "Feasibility dose-volume histogram (DVH)TM " implemented in the PlanIQTM software. METHODS: Using the PlanIQTM software, we retrospectively analyzed the learning curve regarding the quality of the treatment plans for 148 patients of prostate intensity-modulated radiation therapy and volumetric-modulated radiation therapy performed at our institution over the past eight years. We also sought to examine the possibility of improving treatment planning quality by re-planning in 47 patients where the quality of the target dose and the dose limits for organs at risk (OARs) were inadequate. The re-planning treatment plans referred to the Feasibility DVHTM implemented in the PlanIQTM software and modified the treatment planning system based on the target dose and OAR constraints. RESULTS: Analysis of the learning curve of the treatment plans quality using PlanIQTM software retrospectively showed a trend of improvement in the treatment plan quality from year to year. The improvement in the treatment plans quality was more influenced by dose reduction in the OARs than by target coverage. In all cases where re-planning was performed, the improvement in the treatment plan's quality resulted in a better treatment plan than the one adopted for delivery to patients in the clinical plan. CONCLUSIONS: The PlanIQTM provided insights into the quality of the treatment plans at our institution and identified problems and areas for improvement in the treatment plans, allowing for the development of appropriate treatment plans for specific patients.