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Title: Sequential FDG-PET brachytherapy treatment planning in carcinoma of the cervix

Abstract

Purpose: To evaluate the utility of sequential {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging for brachytherapy treatment planning in patients with carcinoma of the cervix. Methods and Materials: Twenty-four patients with carcinoma of the cervix were included in this prospective study. The clinical stage of their disease was Ib (7), IIa (1), IIb (7), and IIIb (9). Patients were treated with irradiation and brachytherapy, with the majority receiving concurrent weekly cisplatin chemotherapy. Patients underwent diagnostic FDG-PET imaging before treatment, sequential FDG-PET brachytherapy imaging during treatment, and diagnostic FDG-PET 3 months after treatment completion. Delineation of the gross tumor volume, bladder, and rectum was performed for all scans using a commercially available treatment-planning system. Actual treatment delivery was based on two-dimensional orthogonal planning. Results: The mean gross tumor volume and percent coverage by the target isodose surface for the initial, mid, and last implant were 37 cm{sup 3}, 17 cm{sup 3}, and 10 cm{sup 3} and 68%, 76%, and 79%, respectively. Nine of 11 patients were found to have continued decrease in tumor volume as measured by FDG-PET, with 3 patients having complete regression of their tumor before treatment was completed. The maximal bladder and rectal doses obtained from three-dimensional dose-volumemore » histograms were significantly higher than the International Commission on Radiation Units and Measurements Report 38 bladder and rectal points obtained by two-dimensional treatment-planning. Conclusions: Sequential FDG-PET brachytherapy imaging identifies the tumor response in individual patients, potentially making patient-specific brachytherapy treatment planning possible.« less

Authors:
 [1];  [2];  [1];  [2];  [1];  [2];  [1];  [2];  [3];  [2];  [1];  [4];  [1];  [2];  [5]
  1. Departments of Radiation Oncology and Radiology, Washington University School of Medicine, St. Louis, MO (United States)
  2. (United States)
  3. Alvin J. Siteman Cancer Center, St. Louis, MO (United States)
  4. Division of Radiological Sciences, Washington University School of Medicine, St. Louis, MO (United States)
  5. Departments of Radiation Oncology and Radiology, Washington University School of Medicine, St. Louis, MO (United States) and Alvin J. Siteman Cancer Center, St. Louis, MO (United States) and Division of Nuclear Medicine, Washington University School of Medicine, St. Louis, MO (United States) and Division of Radiological Sciences, Washington University School of Medicine, St. Louis, MO (United States). E-mail: pgrigsby@wustl.edu
Publication Date:
OSTI Identifier:
20788245
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 63; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2005.05.035; PII: S0360-3016(05)00945-4; Copyright (c) 2005 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; BLADDER; BRACHYTHERAPY; CARCINOMAS; CHEMOTHERAPY; FLUORINE 18; FLUORODEOXYGLUCOSE; PATIENTS; PLANNING; POSITRON COMPUTED TOMOGRAPHY; RADIATION SOURCE IMPLANTS; RECTUM

Citation Formats

Lin, Lilie L., Alvin J. Siteman Cancer Center, St. Louis, MO, Mutic, Sasa M.S., Alvin J. Siteman Cancer Center, St. Louis, MO, Malyapa, Robert S., Alvin J. Siteman Cancer Center, St. Louis, MO, Low, Daniel A., Alvin J. Siteman Cancer Center, St. Louis, MO, Miller, Tom R., Division of Nuclear Medicine, Washington University School of Medicine, St. Louis, MO, Vicic, Milos, LaForest, Richard, Zoberi, Imran, Alvin J. Siteman Cancer Center, St. Louis, MO, and Grigsby, Perry W. Sequential FDG-PET brachytherapy treatment planning in carcinoma of the cervix. United States: N. p., 2005. Web. doi:10.1016/J.IJROBP.2005.0.
Lin, Lilie L., Alvin J. Siteman Cancer Center, St. Louis, MO, Mutic, Sasa M.S., Alvin J. Siteman Cancer Center, St. Louis, MO, Malyapa, Robert S., Alvin J. Siteman Cancer Center, St. Louis, MO, Low, Daniel A., Alvin J. Siteman Cancer Center, St. Louis, MO, Miller, Tom R., Division of Nuclear Medicine, Washington University School of Medicine, St. Louis, MO, Vicic, Milos, LaForest, Richard, Zoberi, Imran, Alvin J. Siteman Cancer Center, St. Louis, MO, & Grigsby, Perry W. Sequential FDG-PET brachytherapy treatment planning in carcinoma of the cervix. United States. doi:10.1016/J.IJROBP.2005.0.
Lin, Lilie L., Alvin J. Siteman Cancer Center, St. Louis, MO, Mutic, Sasa M.S., Alvin J. Siteman Cancer Center, St. Louis, MO, Malyapa, Robert S., Alvin J. Siteman Cancer Center, St. Louis, MO, Low, Daniel A., Alvin J. Siteman Cancer Center, St. Louis, MO, Miller, Tom R., Division of Nuclear Medicine, Washington University School of Medicine, St. Louis, MO, Vicic, Milos, LaForest, Richard, Zoberi, Imran, Alvin J. Siteman Cancer Center, St. Louis, MO, and Grigsby, Perry W. Thu . "Sequential FDG-PET brachytherapy treatment planning in carcinoma of the cervix". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20788245,
title = {Sequential FDG-PET brachytherapy treatment planning in carcinoma of the cervix},
author = {Lin, Lilie L. and Alvin J. Siteman Cancer Center, St. Louis, MO and Mutic, Sasa M.S. and Alvin J. Siteman Cancer Center, St. Louis, MO and Malyapa, Robert S. and Alvin J. Siteman Cancer Center, St. Louis, MO and Low, Daniel A. and Alvin J. Siteman Cancer Center, St. Louis, MO and Miller, Tom R. and Division of Nuclear Medicine, Washington University School of Medicine, St. Louis, MO and Vicic, Milos and LaForest, Richard and Zoberi, Imran and Alvin J. Siteman Cancer Center, St. Louis, MO and Grigsby, Perry W.},
abstractNote = {Purpose: To evaluate the utility of sequential {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging for brachytherapy treatment planning in patients with carcinoma of the cervix. Methods and Materials: Twenty-four patients with carcinoma of the cervix were included in this prospective study. The clinical stage of their disease was Ib (7), IIa (1), IIb (7), and IIIb (9). Patients were treated with irradiation and brachytherapy, with the majority receiving concurrent weekly cisplatin chemotherapy. Patients underwent diagnostic FDG-PET imaging before treatment, sequential FDG-PET brachytherapy imaging during treatment, and diagnostic FDG-PET 3 months after treatment completion. Delineation of the gross tumor volume, bladder, and rectum was performed for all scans using a commercially available treatment-planning system. Actual treatment delivery was based on two-dimensional orthogonal planning. Results: The mean gross tumor volume and percent coverage by the target isodose surface for the initial, mid, and last implant were 37 cm{sup 3}, 17 cm{sup 3}, and 10 cm{sup 3} and 68%, 76%, and 79%, respectively. Nine of 11 patients were found to have continued decrease in tumor volume as measured by FDG-PET, with 3 patients having complete regression of their tumor before treatment was completed. The maximal bladder and rectal doses obtained from three-dimensional dose-volume histograms were significantly higher than the International Commission on Radiation Units and Measurements Report 38 bladder and rectal points obtained by two-dimensional treatment-planning. Conclusions: Sequential FDG-PET brachytherapy imaging identifies the tumor response in individual patients, potentially making patient-specific brachytherapy treatment planning possible.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 63,
place = {United States},
year = {Thu Dec 01 00:00:00 EST 2005},
month = {Thu Dec 01 00:00:00 EST 2005}
}