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Delineation of lung cancer with FDG PET/CT during radiation therapy.
Ganem, J; Thureau, S; Gardin, I; Modzelewski, R; Hapdey, S; Vera, P.
Affiliation
  • Ganem J; Nuclear Medicine Department, Henri Becquerel Cancer Centre and Rouen University Hospital, Rouen, France.
  • Thureau S; QuantIF-LITIS (EA [Equipe d'Accueil] 4108-FR CNRS [Fédération de Recherche-Centre National pour la Recherche Scientifique] 3638), Faculty of Medicine, University of Rouen, Rouen, France.
  • Gardin I; Nuclear Medicine Department, Henri Becquerel Cancer Centre and Rouen University Hospital, Rouen, France. Sebastien.thureau@chb.unicancer.fr.
  • Modzelewski R; QuantIF-LITIS (EA [Equipe d'Accueil] 4108-FR CNRS [Fédération de Recherche-Centre National pour la Recherche Scientifique] 3638), Faculty of Medicine, University of Rouen, Rouen, France. Sebastien.thureau@chb.unicancer.fr.
  • Hapdey S; Department of Radiotherapy and Medical Physics, Henri Becquerel Cancer Centre and Rouen University Hospital, Rouen, France. Sebastien.thureau@chb.unicancer.fr.
  • Vera P; Nuclear Medicine Department, Henri Becquerel Cancer Centre and Rouen University Hospital, Rouen, France.
Radiat Oncol ; 13(1): 219, 2018 Nov 12.
Article in En | MEDLINE | ID: mdl-30419929
OBJECTIVES: To propose an easily applicable segmentation method (perPET-RT) for delineation of tumour volume during radiotherapy on interim fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with non-small cell lung cancer (NSCLC). MATERIAL AND METHODS: Sixty-seven patients (51 primary tumours, 60 lymph nodes), from 4 prospective studies, underwent an FDG PET/CT scan during the fifth week of radiation therapy, using different generations of PET/CT. Per-therapeutic PET/CT scans were delineated in consensus by two experienced physicians leading to the gold standard threshold to be applied. The mathematical expression of Thopt, the optimal threshold to be applied as a function of the maximum standard uptake value (SUVmax), was determined. The performance of this method (perPET-RT) was assessed by computing the DICE similarity coefficient (DSC) and was compared with 8 fixed threshold values and 3 adaptive thresholding methods. RESULTS: Thopt verified the following expression: Thopt = A.ln(1/SUVmax) + B where A and B were 2 constants. A and B were independent from the generation of PET/CT, but depended on the type of lesions (primary lung tumours vs. lymph nodes). PerPET-RT showed good to very good agreement in comparison to the gold standard. The mean and standard deviation of DSC value was 0.81 ± 0.13 for lung lesions and 0.78 ± 0.15 for lymph nodes. PerPET-RT showed a significant better agreement than the other segmentation methods (p < 0.001), except for one of the adaptive thresholding method ADT (p = 0.11). CONCLUSION: On the database used, perPET-RT has proven its reliability and accuracy for tumour delineation on per-therapeutic FDG PET/CT using only SUVmax measurement. This method may be used to delineate tumour volume for dose-escalation planning. TRIAL REGISTRATION: NCT01261598 , NCT01261585 , NCT01576796 .
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Radiotherapy Planning, Computer-Assisted / Carcinoma, Non-Small-Cell Lung / Positron Emission Tomography Computed Tomography / Lung Neoplasms Type of study: Observational_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Radiat Oncol Journal subject: NEOPLASIAS / RADIOTERAPIA Year: 2018 Document type: Article Affiliation country: France Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Radiotherapy Planning, Computer-Assisted / Carcinoma, Non-Small-Cell Lung / Positron Emission Tomography Computed Tomography / Lung Neoplasms Type of study: Observational_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Radiat Oncol Journal subject: NEOPLASIAS / RADIOTERAPIA Year: 2018 Document type: Article Affiliation country: France Country of publication: United kingdom