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Combined F-18-FDG-PET/CT imaging in radiotherapy target delineation for head-and-neck cancer

Guido, Alessandra, Fuccio, Lorenzo, Rombi, Barbara, Castellucci, Paolo, Cecconi, Agnese, Bunkheila, Feisal, Fuccio, Chlara, Spezi, Emiliano, Angelini, Anna Lisa and Barbieri, Enza 2009. Combined F-18-FDG-PET/CT imaging in radiotherapy target delineation for head-and-neck cancer. International Journal of Radiation Oncology - Biology - Physics 73 (3) , pp. 759-763.

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Purpose To evaluate the effect of the use of 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in radiotherapy target delineation for head-and-neck cancer compared with CT alone. Methods and Materials A total of 38 consecutive patients with head-and-neck cancer were included in this study. The primary tumor sites were as follow: 20 oropharyngeal tumors, 4 laryngeal tumors, 2 hypopharyngeal tumors, 2 paranasal sinuses tumors, 9 nasopharyngeal tumors, and 1 parotid gland tumor. The FDG-PET and CT scans were performed with a dedicated PET/CT scanner in one session and then fused. Subsequently, patients underwent treatment planning CT with intravenous contrast enhancement. The radiation oncologist defined all gross tumor volumes (GTVs) using both the PET/CT and CT scans. Results In 35 (92%) of 38 cases, the CT-based GTVs were larger than the PET/CT-based GTVs. The average total GTV from the CT and PET/CT scans was 34.54 cm3 (range, 3.56–109) and 29.38 cm3 (range, 2.87–95.02), respectively (p < 0.05). Separate analyses of the difference between the CT- and PET/CT-based GTVs of the primary tumor compared with the GTVs of nodal disease were not statistically significant. The comparison between the PET/CT-based and CT-based boost planning target volumes did not show a statistically significant difference. All patients were alive at the end of the follow-up period (range, 3–38 months). Conclusion GTVs, but not planning target volumes, were significantly changed by the implementation of combined PET/CT. Large multicenter studies are needed to ascertain whether combined PET/CT in target delineation can influence the main clinical outcomes.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Engineering
Publisher: Elsevier
ISSN: 0360-3016
Last Modified: 04 Jun 2017 08:05

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