[{sup 18}F]FDG-Positron Emission Tomography Coregistration With Computed Tomography Scans for Radiation Treatment Planning of Lymphoma and Hematologic Malignancies
- Department of Radiation Oncology Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)
- Department of Radiology, Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)
- Memorial Sloan-Kettering Cancer Center, New York, New York (United States)
Purpose: Positron emission-tomography (PET) using 2-[{sup 18}F]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.
- OSTI ID:
- 21590411
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 81, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2010.06.044; PII: S0360-3016(10)00895-3; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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