Comparison of CT- and FDG-PET-defined gross tumor volume in intensity-modulated radiotherapy for head-and-neck cancer

Journal Article · Fri Apr 01 04:00:00 EST 2005 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2004.08.037· OSTI ID:20696171

Paulino, Arnold C ^[1]; Koshy, Mary ^[1]; Howell, Rebecca ^[1]; Schuster, David ^[2]; Davis, Lawrence W ^[1]

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1. Department of Radiation Oncology, Division of Nuclear Medicine and Molecular Imaging, Emory Clinic and Emory University, Atlanta, GA (United States)
2. Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Emory Clinic and Emory University, Atlanta, GA (United States)

Purpose: To compare the gross tumor volume (GTV) identified on CT to that obtained from fluorodeoxyglucose (FDG) positron emission tomography (PET) and determine the differences in volume and dose coverage of the PET-GTV when the CT-GTV is used for radiotherapy planning. Methods and Materials: A total of 40 patients with intact squamous cell carcinoma arising in the head-and-neck region underwent intensity-modulated radiotherapy (IMRT) at one department. All patients underwent CT simulation for treatment planning followed by PET-CT in the treatment position. CT simulation images were fused to the CT component of the PET-CT images. The GTV using the CT simulation images was contoured (CT-GTV), as was the GTV based on the PET scan (PET-GTV). The IMRT plans were obtained using the CT-GTV. Results: The PET-GTV was smaller, the same size, and larger than the CT-GTV in 30 (75%), 3 (8%), and 7 (18%) cases respectively. The median PET-GTV and CT-GTV volume was 20.3 cm{sup 3} (range, 0.2-294) and 37.2 cm{sup 3} (range, 2-456), respectively. The volume of PET-GTV receiving at least 95% of the prescribed dose was 100% in 20 (50%), 95-99% in 10 (25%), 90-94% in 3 (8%), 85-89% in 1 (3%), 80-84% in 2 (5%), 75-79% in 1 (3%), and <75% in 3 (8%) cases. The minimal dose received by 95% of the PET-GTV was {>=}100% in 19 (48%), 95-99% in 11 (28%), 90-94% in 5 (13%), 85-89% in 2 (5%), and <75% in 3 (8%) cases. Conclusion: The PET-GTV was larger than the CT-GTV in 18% of cases. In approximately 25% of patients with intact head-and-neck cancer treated using IMRT, the volume of PET-GTV receiving at least 95% of the prescribed dose and minimal dose received by 95% of the PET-GTV were less than optimal.

• OSTI ID: 20696171
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 61; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
COMPARATIVE EVALUATIONS
COMPUTERIZED TOMOGRAPHY
FLUORODEOXYGLUCOSE
HEAD
IMAGES
NECK
PATIENTS
PLANNING
POSITRON COMPUTED TOMOGRAPHY
RADIATION DOSES
RADIOTHERAPY
SIMULATION