Comparison of {sup 18}F-Fluorothymidine and {sup 18}F-Fluorodeoxyglucose PET/CT in Delineating Gross Tumor Volume by Optimal Threshold in Patients With Squamous Cell Carcinoma of Thoracic Esophagus

Journal Article · Mon Mar 15 04:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

OSTI ID:21372185

Dali, Han ^[1]; Yonghua, Yu; Guifang, Zhang; Xiaojun, Zhong; Jie, Lu; Yong, Yin ^[1]; Zheng, Fu ^[2]; Dianbin, Mu ^[3]; Baijiang, Zhang ^[4]; Wei, He; Zhijun, Huo; Xijun, Liu; Lei, Kong ^[1]; Shuqiang, Zhao ^[2]; Xiangyu, Sun ^[3]

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1. Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province (China)
2. Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Jinan, Shandong Province (China)
3. Department of Pathology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province (China)
4. Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Jinan, Shandong Province (China)

Purpose: To determine the optimal method of using {sup 18}F-fluorothymidine (FLT) positron emission tomography (PET)/computed tomography (CT) simulation to delineate the gross tumor volume (GTV) in esophageal squamous cell carcinoma verified by pathologic examination and compare the results with those using {sup 18}F-fluorodeoxyglucose (FDG) PET/CT. Methods and Materials: A total of 22 patients were enrolled and underwent both FLT and FDG PET/CT. The GTVs with biologic information were delineated using seven different methods in FLT PET/CT and three different methods in FDG PET/CT. The results were compared with the pathologic gross tumor length, and the optimal threshold was obtained. Next, we compared the simulation plans using the optimal threshold of FLT and FDG PET/CT. The radiation dose was prescribed as 60 Gy in 30 fractions with a precise radiotherapy technique. Results: The mean +- standard deviation pathologic gross tumor length was 4.94 +- 2.21 cm. On FLT PET/CT, the length of the standardized uptake value 1.4 was 4.91 +- 2.43 cm. On FDG PET/CT, the length of the standardized uptake value 2.5 was 5.10 +- 2.18 cm, both of which seemed more approximate to the pathologic gross tumor length. The differences in the bilateral lung volume receiving >=20 Gy, heart volume receiving >=40 Gy, and the maximal dose received by spinal cord between FLT and FDG were not significant. However, the values for mean lung dose, bilateral lung volume receiving >=5, >=10, >=30, >=40, and >=50 Gy, mean heart dose, and heart volume receiving >=30 Gy using FLT PET/CT-based planning were significant lower than those using FDG PET/CT. Conclusion: A standardized uptake value cutoff of 1.4 on FLT PET/CT and one of 2.5 on FDG PET/CT provided the closest estimation of GTV length. Finally, FLT PET/CT-based treatment planning provided potential benefits to the lungs and heart.

• OSTI ID: 21372185
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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