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Title: Advances in image-guided radiation therapy-the role of PET-CT

Abstract

In the era of image-guided radiation therapy (IGRT), the greatest challenge remains target delineation, as the opportunity to maximize cures while simultaneously decreasing radiation dose to the surrounding normal tissues is to be realized. Over the last 2 decades, technological advances in radiographic imaging, biochemistry, and molecular biology have played an increasing role in radiation treatment planning, delivery, and evaluation of response. Previously, fluoroscopy formed the basis of radiation treatment planning. Beginning in the late 1980s, computed tomography (CT) has become the basis for modern radiation treatment planning and delivery, coincident with the rise of 3-dimensional conformal radiation therapy (3DCRT). Additionally, multi-modality anatomic imaging registration was the solution pursued to augment delineation of tumors and surrounding structures on CT-based treatment planning. Although these imaging modalities provide the customary anatomic details necessary for radiation treatment planning, they have limitations, including difficulty with identification of small tumor deposits, tumor extension, and distinction from scar tissues. To overcome these limitations, PET and, more recently, PET-CT have been innovative regarding the extent of disease appraisal, target delineation in the treatment planning, and assessment of therapy response. We review the role of functional imaging in IGRT as it reassures transformations on the field of radiationmore » oncology. As we move toward the era of IGRT, the use of multi-modality imaging fusion, and the introduction of more sensitive and specific PET-CT tracers may further assist target definition. Furthermore, the potential to predict early outcome or even detect early recurrence of tumor, may allow for the tailoring of intervention in cancer patients. The convergence of a biological target volume, and perhaps multi-tracer tumor, molecular, and genetic profile tumors will probably be vital in cancer treatment selection. Nevertheless, prospective clinical experience with outcome is encouraged and needs to be expanded to entirely exploit the benefits of the IGRT.« less

Authors:
 [1];  [2];  [2]
  1. Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States). E-mail: heronD2@upmc.edu
  2. Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)
Publication Date:
OSTI Identifier:
20783352
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 31; Journal Issue: 1; Other Information: DOI: 10.1016/j.meddos.2005.12.006; PII: S0958-3947(05)00204-9; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOCHEMISTRY; COMPUTERIZED TOMOGRAPHY; FLUOROSCOPY; IMAGES; MOLECULAR BIOLOGY; NEOPLASMS; PLANNING; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Heron, Dwight E., Smith, Ryan P., and Andrade, Regiane S. Advances in image-guided radiation therapy-the role of PET-CT. United States: N. p., 2006. Web. doi:10.1016/j.meddos.2005.12.006.
Heron, Dwight E., Smith, Ryan P., & Andrade, Regiane S. Advances in image-guided radiation therapy-the role of PET-CT. United States. doi:10.1016/j.meddos.2005.12.006.
Heron, Dwight E., Smith, Ryan P., and Andrade, Regiane S. Sat . "Advances in image-guided radiation therapy-the role of PET-CT". United States. doi:10.1016/j.meddos.2005.12.006.
@article{osti_20783352,
title = {Advances in image-guided radiation therapy-the role of PET-CT},
author = {Heron, Dwight E. and Smith, Ryan P. and Andrade, Regiane S.},
abstractNote = {In the era of image-guided radiation therapy (IGRT), the greatest challenge remains target delineation, as the opportunity to maximize cures while simultaneously decreasing radiation dose to the surrounding normal tissues is to be realized. Over the last 2 decades, technological advances in radiographic imaging, biochemistry, and molecular biology have played an increasing role in radiation treatment planning, delivery, and evaluation of response. Previously, fluoroscopy formed the basis of radiation treatment planning. Beginning in the late 1980s, computed tomography (CT) has become the basis for modern radiation treatment planning and delivery, coincident with the rise of 3-dimensional conformal radiation therapy (3DCRT). Additionally, multi-modality anatomic imaging registration was the solution pursued to augment delineation of tumors and surrounding structures on CT-based treatment planning. Although these imaging modalities provide the customary anatomic details necessary for radiation treatment planning, they have limitations, including difficulty with identification of small tumor deposits, tumor extension, and distinction from scar tissues. To overcome these limitations, PET and, more recently, PET-CT have been innovative regarding the extent of disease appraisal, target delineation in the treatment planning, and assessment of therapy response. We review the role of functional imaging in IGRT as it reassures transformations on the field of radiation oncology. As we move toward the era of IGRT, the use of multi-modality imaging fusion, and the introduction of more sensitive and specific PET-CT tracers may further assist target definition. Furthermore, the potential to predict early outcome or even detect early recurrence of tumor, may allow for the tailoring of intervention in cancer patients. The convergence of a biological target volume, and perhaps multi-tracer tumor, molecular, and genetic profile tumors will probably be vital in cancer treatment selection. Nevertheless, prospective clinical experience with outcome is encouraged and needs to be expanded to entirely exploit the benefits of the IGRT.},
doi = {10.1016/j.meddos.2005.12.006},
journal = {Medical Dosimetry},
number = 1,
volume = 31,
place = {United States},
year = {Sat Apr 01 00:00:00 EST 2006},
month = {Sat Apr 01 00:00:00 EST 2006}
}