scholarly journals Impact of FAPI-PET/CT on Target Volume Definition in Radiation Therapy of Locally Recurrent Pancreatic Cancer

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 796
Author(s):  
Jakob Liermann ◽  
Mustafa Syed ◽  
Edgar Ben-Josef ◽  
Kai Schubert ◽  
Ingmar Schlampp ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Target Volume ◽  
Radiation Oncologists ◽  
Pet Ct ◽  
Significant Difference ◽  
Target Definition ◽  
Recurrent Pancreatic Cancer ◽  
Locally Recurrent

(1) Background: A new radioactive positron emission tomography (PET) tracer uses inhibitors of fibroblast activation protein (FAPI) to visualize FAP-expressing cancer associated fibroblasts. Significant FAPI-uptake has recently been demonstrated in pancreatic cancer patients. Target volume delineation for radiation therapy still relies on often less precise conventional computed tomography (CT) imaging, especially in locally recurrent pancreatic cancer patients. The need for improvement in precise tumor detection and delineation led us to innovatively use the novel FAPI-PET/CT for radiation treatment planning. (2) Methods: Gross tumor volumes (GTVs) of seven locally recurrent pancreatic cancer cases were contoured by six radiation oncologists. In addition, FAPI-PET/CT was used to automatically delineate tumors. The interobserver variability in target definition was analyzed and FAPI-based automatic GTVs were compared to the manually defined GTVs. (3) Results: Target definition differed significantly between different radiation oncologists with mean dice similarity coefficients (DSCs) between 0.55 and 0.65. There was no significant difference between the volumes of automatic FAPI-GTVs based on the threshold of 2.0 and most of the manually contoured GTVs by radiation oncologists. (4) Conclusion: Due to its high tumor to background contrast, FAPI-PET/CT seems to be a superior imaging modality compared to the current gold standard contrast-enhanced CT in pancreatic cancer. For the first time, we demonstrate how FAPI-PET/CT could facilitate target definition and increases consistency in radiation oncology in pancreatic cancer.

Biologic target volume delineation and the application of three-dimensional ultrasound image system in hypofractional radiotherapy for prostate cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16585-e16585
Author(s):  
Jie Wang ◽  
Jiabao Ma ◽  
Jin Yi Lang
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Target Volume ◽  
Emission Computed Tomography ◽  
Resonance Spectroscopy ◽  
Radiation Oncologists ◽  
Biological Target Volume ◽  
Pet Ct ◽  
Significant Difference ◽  
Prescription Dose

e16585 Background: To investigate the value of magnetic resonance spectroscopy (MRS) and positron emission computed tomography (PET-CT) in biological target volume(BTV) delineation of prostate cancer using hypofractional intensity modulated radiotherapy (HF-IMRT) with simultaneously integrated boost(SIB), and the preliminary efficacy and adverse effects of 3D ultrasound (3DUS) guided imaging in the treatment of prostate cancer using HF-IMRT and SIB. Methods: Between August 2015 and May 2016, 13 patients diagnosed with mid-high risk prostate cancer were retrospectively enrolled. All the eligible patients had underwent MRI MRS and PET-CT(18F-FDG or 11C-CHO) examination before radiotherapy. 5 patients had explicit BTV by examinations mentioned above. Radiation oncologists fused 3DUS and CT images and delineated tumor target volume referring to MRS and PET-CT. The target volumes were named as GTVMRI BTVMRS BTVPET-CT respectively and the volume were recorded. 3DUS guided HF-IMRT were applied during the radiotherapy. Results: The volumes of GTVMRI BTVMRS BTVPET-CT among the 5 patients were different. The mean volume of GTVMRI BTVMRS and BTVPET-CT were 3.52±1.69cm3, 6.64±2.27cm3 and 5.47±2.60cm3,respectively. Significant difference was only observed between GTVMRI and BTVMRS( P = 0.046). Compared to GTVMRI, the average increasing volumes of BTVMRS and BTVPET-CT were 89.07% and 55.52%. The prescription dose and biological effective dose(BED) of BTVMRS were 70.09-73.45Gy and 129.06-135.54Gy. The prescription dose and BED of the whole prostate were 66.02-69.40Gy and 113.32-124.82Gy. The dose of bladder and rectum were within safe control. The prostate specific antigen (PSA) were significantly decreased after radiotherapy. No local recurrence or distant metastasis was observed. Conclusions: MRS and PET-CT can be applied to delineation of the BTV of prostate cancer. With the help of multi-modal image guidance, dose painting for prostate cancer is feasible. 3DUS guided HF-IMRT with SIB is an alternative for radiation oncologists based on BTVMRS. With shortened time and less cost, this technique is safe and non-radioactive compared to CBCT guidance.

scholarly journals 18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382110246
Author(s):  
Seokmo Lee ◽  
Yunseon Choi ◽  
Geumju Park ◽  
Sunmi Jo ◽  
Sun Seong Lee ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Concurrent Chemoradiotherapy ◽  
Curative Intent ◽  
Squamous Cell Esophageal Cancer ◽  
Pet Ct ◽  
Significant Difference ◽  
Fdg Pet Ct

Background and Aims: This study evaluated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) performed before and after concurrent chemoradiotherapy (CCRT) in esophageal cancer. Methods: We analyzed the prognosis of 50 non-metastatic squamous cell esophageal cancer (T1-4N0-2) patients who underwent CCRT with curative intent at Inje University Busan Paik Hospital and Haeundae Paik Hospital from 2009 to 2019. Median total radiation dose was 54 Gy (range 34-66 Gy). Our aim was to investigate the relationship between PET/CT values and prognosis. The primary end point was progression-free survival (PFS). Results: The median follow-up period was 9.9 months (range 1.7-85.7). Median baseline maximum standard uptake value (SUVmax) was 14.2 (range 3.2-27.7). After treatment, 29 patients (58%) showed disease progression. The 3-year PFS and overall survival (OS) were 24.2% and 54.5%, respectively. PFS was significantly lower ( P = 0.015) when SUVmax of initial PET/CT exceeded 10 (n = 22). However, OS did not reach a significant difference based on maximum SUV ( P = 0.282). Small metabolic tumor volume (≤14.1) was related with good PFS ( P = 0.002) and OS ( P = 0.001). Small total lesion of glycolysis (≤107.3) also had a significant good prognostic effect on PFS ( P = 0.009) and OS ( P = 0.025). In a subgroup analysis of 18 patients with follow-up PET/CT, the patients with SUV max ≤3.5 in follow-up PET/CT showed longer PFS ( P = 0.028) than those with a maximum SUV >3.5. Conclusion: Maximum SUV of PET/CT is useful in predicting prognosis of esophageal cancer patients treated with CCRT. Efforts to find more effective treatments for patients at high risk of progression are still warranted.

scholarly journals Determination of Radiosurgery Treatment Volume for Intracranial Germ Cell Tumors (GCTS)

2020 ◽  
Vol 8 (3) ◽  
Author(s):  
Murat Beyzadeoglu ◽  
Ferrat Dincoglan ◽  
Omer Sager ◽  
Selcuk Demiral
Keyword(s):  
Germ Cell ◽  
Background Radiation ◽  
Germ Cell Tumors ◽  
Target Volume ◽  
Whole Brain Irradiation ◽  
Volume Determination ◽  
Radiation Oncologists ◽  
Intracranial Germ Cell Tumors ◽  
Target Definition ◽  
Treatment Volume

Background: Radiation therapy (RT) volumes for intracranial germ cell tumors (GCTs) may include focal treatment volumes, whole ventricle irradiation, whole brain irradiation, or irradiation of the entire neuroaxis. RT doses and volumes for management of primary intracranial GCTs have been an area of active research over the years. Improved sparing of critical organs by use of less extensive RT volumes and lower doses has been investigated for avoiding excessive morbidity of treatment. Herein, we assess intracranial GCT treatment volume determination. Methods: Treatment volume definition for intracranial GCT by incorporation of Magnetic Resonance Imaging (MRI) was comparatively assessed in our study. Reference volume for comparison purposes was defined after thorough assessment and collaboration of the board certified radiation oncologists. Definition of radiosurgery target volume was based solely on CT images or fusion of CT with MRI. Comparative evaluation of treatment volume determination was performed. Results: Ground truth target volume defined after thorough evaluation and collaboration of the board certified radiation oncologists was similar with treatment volume definition based on CT-MR fusion based imaging. Conclusions: In conclusion, radiosurgery treatment planning for intracranial GCTs may be improved by incorporation of MRI into target definition process. Clearly, further studies are warranted to draw firm conclusions on optimal target definition for intracranial GCT radiosurgery.  

scholarly journals Dosimetric Comparison of Three Radiotherapy Techniques in Irradiation of Left-Sided Breast Cancer Patients after Radical Mastectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jian Hu ◽  
Guang Han ◽  
Yu Lei ◽  
Ximing Xu ◽  
Wei Ge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Radical Mastectomy ◽  
Target Volume ◽  
Conformity Index ◽  
Breast Cancer Patients ◽  
Ipsilateral Lung ◽  
Significant Difference

Introduction. This study is aimed at evaluating the dosimetric differences among target segmented planning (TSP), conventional 9-field intensity modulated radiation therapy (9FIMRT) planning, and volumetric modulated arc therapy (VMAT) planning for postmastectomy radiotherapy of left-sided breast cancer patients. Material and Methods. Fifteen left-sided breast cancer patients who underwent radical mastectomy were enrolled. In TSP, the planning target volume (PTV) was divided into four regions (supra/infraclavicular, chest wall, external mammary region, and internal mammary region), and each individual PTV region was treated with respective fixed fields. Results. The VMAT plans showed superior to PTV dose conformity index (CI), homogeneity index (HI), protection of the ipsilateral lung, monitor units (MUs), and maximum dose (Dmax) to the contralateral breast compared with TSP and 9FIMRT plans. The TSP provided better protection for Dmean of the heart and left ventricle (p<0.05). A dose for left anterior descending artery from the three techniques had no significant difference. Compared with the 9FIMRT plans, the V5Gy (%) and V10Gy (%) for the ipsilateral lung were significantly reduced with TSP and VMAT (p<0.05). The V5Gy (%) and V10Gy (%) for the ipsilateral lung turned out to be similar between VMAT and TSP techniques. Conclusions. Our study indicates that VMAT should be a better choice of radiotherapy for left-sided breast cancer patients after radical mastectomy. If VMAT is unavailable, 9FIMRT can achieve better CI and HI values and be more MU-efficient compared with TSP; however, TSP can effectively reduce the low dose volume of the ipsilateral lungs and heart.

Self-Reported Sexual, Bowel and Bladder Function in Cervical Cancer Patients Following Different Treatment Modalities: Longitudinal Prospective Cohort Study

2013 ◽  
Vol 23 (9) ◽  
pp. 1717-1725 ◽  
Author(s):  
Quirine D. Pieterse ◽  
Gemma G. Kenter ◽  
Cornelis P. Maas ◽  
Cor D. de Kroon ◽  
Carien L. Creutzberg ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Cohort Study ◽  
Cancer Patients ◽  
Early Stage ◽  
Unexpected Finding ◽  
Prognostic Features ◽  
Sexual Symptoms ◽  
Significant Difference ◽  
Early Stage Cervical Cancer

ObjectiveConventional radical hysterectomy with pelvic lymphadenectomy (RHL) for early-stage cervical cancer is associated with significant bladder, anorectal, and sexual dysfunction. Nerve-sparing modification of RHL (NS-RHL) has been developed with the aim to reduce surgical treatment-related morbidity. Postoperative radiation therapy (RT) is offered to patients with unfavorable prognostic features to improve local control. The aim of the study was to assess self-reported morbidity of various types of treatment in cervical cancer patients.MethodsSelf-reported symptoms were prospectively assessed before and 1 and 2 years after treatment by the Dutch Gynaecologic Leiden Questionnaire.ResultsIncluded were 229 women (123 NS-RHL and 106 conventional RHL). Ninety-four (41%) received RT. Up to 2 years (response rate, 81%), women reported significantly more bowel, bladder, and sexual symptoms compared with the pretreatment situation. No significant difference was found between the conventional RHL and NS-RHL with the exception of the unexpected finding that a smaller percentage in the NS-RHL group (34% vs 68%) complained about numbness of the labia and/ or thigh. Radiation therapy had a negative impact on diarrhea, urine incontinence, lymphedema, and sexual symptoms (especially a narrow/short vagina).ConclusionsIn the current longitudinal cohort study, treatment for early-stage cervical cancer was associated with worse subjective bladder, anorectal, and sexual functioning, irrespective of the surgical procedure used. Postoperative RT resulted in a significant deterioration of these functions. The results have to be interpreted with caution in view of the study design and method used.

Sign in / Sign up

Export Citation Format

Share Document