scholarly journals Additional Value of 18F-FDOPA Amino Acid Analog Radiotracer to Irradiation Planning Process of Patients With Glioblastoma Multiforme

2021 ◽  
Vol 11 ◽  
Author(s):  
David Sipos ◽  
Zoltan László ◽  
Zoltan Tóth ◽  
Peter Kovács ◽  
Jozsef Tollár ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Planning Process ◽  
Single Case ◽  
Safety Margin ◽  
Target Volume ◽  
Added Value ◽  
Radiotherapy Planning ◽  
Volumetric Assessment ◽  
Biological Target Volume ◽  
Pet Ct

PurposeTo investigate the added value of 6-(18F]-fluoro-L-3,4-dihydroxyphenylalanine (FDOPA) PET to radiotherapy planning in glioblastoma multiforme (GBM).MethodsFrom September 2017 to December 2020, 17 patients with GBM received external beam radiotherapy up to 60 Gy with concurrent and adjuvant temozolamide. Target volume delineations followed the European guideline with a 2-cm safety margin clinical target volume (CTV) around the contrast-enhanced lesion+resection cavity on MRI gross tumor volume (GTV). All patients had FDOPA hybrid PET/MRI followed by PET/CT before radiotherapy planning. PET segmentation followed international recommendation: T/N 1.7 (BTV1.7) and T/N 2 (BTV2.0) SUV thresholds were used for biological target volume (BTV) delineation. For GTV-BTVs agreements, 95% of the Hausdorff distance (HD95%) from GTV to the BTVs were calculated, additionally, BTV portions outside of the GTV and coverage by the 95% isodose contours were also determined. In case of recurrence, the latest MR images were co-registered to planning CT to evaluate its location relative to BTVs and 95% isodose contours.ResultsAverage (range) GTV, BTV1.7, and BTV2.0 were 46.58 (6–182.5), 68.68 (9.6–204.1), 42.89 (3.8–147.6) cm3, respectively. HD95% from GTV were 15.5 mm (7.9–30.7 mm) and 10.5 mm (4.3–21.4 mm) for BTV1.7 and BTV2.0, respectively. Based on volumetric assessment, 58.8% (28–100%) of BTV1.7 and 45.7% of BTV2.0 (14-100%) were outside of the standard GTV, still all BTVs were encompassed by the 95% dose. All recurrences were confirmed by follow-up imaging, all occurred within PTV, with an additional outfield recurrence in a single case, which was not DOPA-positive at the beginning of treatment. Good correlation was found between the mean and median values of PET/CT and PET/MRI segmented volumes relative to corresponding brain-accumulated enhancement (r = 0.75; r = 0.72).Conclusion18FFDOPA PET resulted in substantial larger tumor volumes compared to MRI; however, its added value is unclear as vast majority of recurrences occurred within the prescribed dose level. Use of PET/CT signals proved to be feasible in the absence of direct segmentation possibilities of PET/MR in TPS. The added value of 18FFDOPA may be better exploited in the context of integrated dose escalation.

scholarly journals The role of PET-CT in radiotherapy planning of solid tumours

2015 ◽  
Vol 49 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Stasa Jelercic ◽  
Mirjana Rajer
Keyword(s):  
Treatment Planning ◽  
Planning Process ◽  
Diagnostic Procedures ◽  
Solid Tumours ◽  
Radiotherapy Planning ◽  
Radiotherapy Treatment Planning ◽  
Pet Ct ◽  
Target Volumes ◽  
Radiotherapy Treatment

AbstractBackground. PET-CT is becoming more and more important in various aspects of oncology. Until recently it was used mainly as part of diagnostic procedures and for evaluation of treatment results. With development of personalized radiotherapy, volumetric and radiobiological characteristics of individual tumour have become integrated in the multistep radiotherapy (RT) planning process. Standard anatomical imaging used to select and delineate RT target volumes can be enriched by the information on tumour biology gained by PET-CT. In this review we explore the current and possible future role of PET-CT in radiotherapy treatment planning. After general explanation, we assess its role in radiotherapy of those solid tumours for which PET-CT is being used most.Conclusions. In the nearby future PET-CT will be an integral part of the most radiotherapy treatment planning procedures in an every-day clinical practice. Apart from a clear role in radiation planning of lung cancer, with forthcoming clinical trials, we will get more evidence of the optimal use of PET-CT in radiotherapy planning of other solid tumours

Radiotherapy planning: PET/CT scanner performances in the definition of gross tumour volume and clinical target volume

2005 ◽  
Vol 32 (12) ◽  
pp. 1392-1399 ◽  
Author(s):  
Ernesto Brianzoni ◽  
Gloria Rossi ◽  
Sergio Ancidei ◽  
Alfonso Berbellini ◽  
Francesca Capoccetti ◽  
...  
Keyword(s):  
Clinical Target Volume ◽  
Tumour Volume ◽  
Target Volume ◽  
Radiotherapy Planning ◽  
Gross Tumour Volume ◽  
Ct Scanner ◽  
Pet Ct ◽  
Definition Of

scholarly journals Radiotherapy planning: PET/CT scanner performances in the definition of gross tumour volume and clinical target volume

2005 ◽  
Vol 32 (12) ◽  
pp. 1491-1491
Author(s):  
Ernesto Brianzoni ◽  
Gloria Rossi ◽  
Sergio Ancidei ◽  
Alfonso Berbellini ◽  
Francesca Capoccetti ◽  
...  
Keyword(s):  
Clinical Target Volume ◽  
Tumour Volume ◽  
Target Volume ◽  
Radiotherapy Planning ◽  
Gross Tumour Volume ◽  
Ct Scanner ◽  
Pet Ct ◽  
Definition Of

scholarly journals Correlation of [18F] FDG-PET/CT with dosimetry data: recurrence pattern after radiotherapy for head and neck carcinoma

2020 ◽  
Author(s):  
Carla Pisani ◽  
Luca Vigna ◽  
Federico Mastroleo ◽  
Gianfranco Loi ◽  
Valentina Amisano ◽  
...  
Keyword(s):  
Head And Neck ◽  
Fdg Pet ◽  
Head And Neck Carcinoma ◽  
Target Volume ◽  
Local Relapse ◽  
Biological Target Volume ◽  
Pet Ct ◽  
The Mean ◽  
Pre Treatment ◽  
Fdg Pet Ct

Abstract ObjectiveTo analyze the pattern of failure in relation to pre-treatment [18F] FDG-PET/CT uptake in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive radio-chemotherapy (RT-CHT).Methods and MaterialsFrom 2012 to 2016, 87 HNSCC patients treated with definitive RT-CHT, with intensity modulated radiation therapy with simultaneous integrated boost (IMRT-SIB), underwent pre-treatment [18F] FDG-PET/CT (PETpre), and MRI/CT for radiotherapy (RT) planning purposes. Patients with local recurrence, received [18F] FDG-PET/CT, (PETrec) at the time of the discovery of recurrence. In these patients, the biological target volume (BTV), BTVpre and BTVrec were segmented on PET images by means of an adaptive thresholding algorithm. The overlapping volume between BTVpre and BTVrec (BTVpre&rec) was generated and the dose coverage of BTVrec and BTVpre&rec was checked on the planning CT using the D99 and D95 dose metrics. The recurrent volume was defined as: ‘‘In-Field (IF)’’, ‘‘Extending Outside the Field (EOF)’’ or ‘‘Out-of-Field (OF)’’ if D95 was respectively equal or higher than 95%, D95 was between 95% and 20% or the D95 was less than 20% of prescribed dose.ResultsWe found 10/87 patients (11.5%) who had recurrence at primary site. Mean BTVpre was 13.1 cc (4.6-37.4 cc), while the mean BTVrec was 4.3 cc (1.1-12.7 cc). Two recurrences resulted 100% inside BTVpre, 4 recurrences were mostly inside (61%-91%) and 4 recurrences were marginal to BTVpre (33-1%). At dosimetric analysis, six recurrences (60%) were IF, 3 (30%) EOF and one (10%) OF. The mean D99 of the overlapping volumes BTVpre&rec was 68.1Gy (66.5-69.2 Gy), considering a prescription dose of 70 Gy to the planning target volume (PTV). ConclusionOur study shows that the recurrence may originate from the volume with the highest FDG-signal. Results support the hypothesis that an intensification of the dose on these volumes could be helpful to prevent local relapse.

scholarly journals Visualization of 4D-PET/CT, Target Volumes and Dose Distribution: Applications in Radiotherapy Planning

2014 ◽  
Author(s):  
Matthias Schlachter ◽  
Tobias Fechter ◽  
Ursula Nestle ◽  
Katja Bühler
Keyword(s):  
Dose Distribution ◽  
Visual Information ◽  
Radiation Treatment ◽  
Target Volume ◽  
Radiotherapy Planning ◽  
Medical Doctors ◽  
Visualization System ◽  
Volume Delineation ◽  
Pet Ct ◽  
Target Volumes

In radiation treatment (RT) planning medical doctors need to consider a variety of information sources for anatomical and functional target volume delineation. The validation and inspection of the defined target volumes and the resulting RT plan is a complex task, especially in the presence of moving target areas as it is the case for tumors of the chest and the upper abdomen. A 4D-PET/CT visualization system may become a helpful tool for validating RT plans. We define major requirements such a visualization system should fulfill to provide medical doctors with the necessary visual information to validate tumor delineations, and review the dose distribution of a RT plan. We present an implementation of such a system, and present qualitative results of its applications for a lung cancer patient.

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