[(18)F]FDG-positron emission tomography coregistration with computed tomography scans for radiation treatment planning of lymphoma and hematologic malignancies Journal Article
| Authors: | Terezakis, S. A.; Hunt, M. A.; Kowalski, A.; Mccann, P.; Schmidtlein, C. R.; Reiner, A.; Gonen, M.; Kirov, A. S.; Gonzales, A. M.; Schoder, H.; Yahalom, J. |
| Article Title: | [(18)F]FDG-positron emission tomography coregistration with computed tomography scans for radiation treatment planning of lymphoma and hematologic malignancies |
| Abstract: | Purpose: Positron emission-tomography (PET) using 2-[18F]fluoro- 2-deoxyglucose (FDG-PET) increases sensitivity and specificity of disease detection in lymphoma and thus is standard in lymphoma management. This study examines the effects of coregistering FDG-PET and computed tomography (CT) (PET/CT) scans on treatment planning for lymphoma patients. Methods and Materials: Twenty-nine patients (30 positive PET scans) underwent PET/CT treatment planning from July 2004 to February 2007 and were retrospectively studied. For each patient, gross tumor volume was blindly contoured on the CT-only and PET/CT studies by a radiation oncologist. Treatment plans were generated for both the CT-only and PET/CT planning target volumes (PTVs) for all patients. Normal tissue doses and PTV coverage were evaluated using dose - volume histograms for all sites. Results: Thirty-two treatment sites were evaluated. Twenty-one patients had non-Hodgkin lymphoma, 5 patients had Hodgkin lymphoma, and 3 patients had plasma cell neoplasms. Previously undetected FDG-avid sites were identified in 3 patients during PET/CT simulation, resulting in one additional treatment field. Due to unexpected PET/CT simulation findings, 2 patients did not proceed with radiation treatment. The addition of PET changed the volume of 23 sites (72%). The PTV was increased in 15 sites (47%) by a median of 11% (range, 6-40%) and reduced in 8 sites (25%) by a median of 20% (range, 6%-75%). In six (19%) replanned sites, the CT-based treatment plan would not have adequately covered the PTV defined by PET/CT. Conclusions: Incorporation of FDG-PET into CT-based treatment planning for lymphoma patients resulted in considerable changes in management, volume definition, and normal tissue dosimetry for a significant number of patients. © 2011 Elsevier Inc. |
| Keywords: | lymphoma; [18f]fdg-pet; involved field radiation; pet/ct radiation planning; target volume definition |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 81 |
| Issue: | 3 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2011-11-01 |
| Start Page: | 615 |
| End Page: | 622 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2010.06.044 |
| PROVIDER: | scopus |
| PUBMED: | 20933343 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 November 2011" - "CODEN: IOBPD" - "Source: Scopus" |
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