Comparison of Standardized Uptake Value-Based Positron Emission Tomography and Computed Tomography Target Volumes in Esophageal Cancer Patients Undergoing Radiotherapy

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

DOI:https://doi.org/10.1016/j.ijrobp.2009.09.022· OSTI ID:21438040

Vali, Faisal S ^[1]; Nagda, Suneel ^[1]; Hall, William ^[1]; Sinacore, James ^[2]; Mingcheng, Gao ^[1]; Lee, Steven H ^[3]; Hong, Robert ^[4]; Shoup, Margaret ^[5]; Emami, Bahman ^[1]

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1. Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL (United States)
2. Department of Preventive Medicine and Epidemiology, Loyola University Medical Center, Maywood, IL (United States)
3. Department of Radiology, Section of Nuclear Medicine, Orlando VA Medical Center, Orlando, FL (United States)
4. Department of Radiation Oncology, Virginia Hospital Center, Arlington, VA (United States)
5. Division of Surgical Oncology, Department of Surgery, Loyola University Medical Center, Maywood, IL (United States)

Purpose: To study various standardized uptake value (SUV)-based approaches to ascertain the best strategy for delineating metabolic tumor volumes (MTV). Methods and Materials: Twenty-two consecutive previously treated esophageal cancer patients with positron emission tomography (PET) imaging and computed tomography (CT)-based radiotherapy plans were studied. At the level of the tumor epicenter, MTVs were delineated at 11 different thresholds: SUV {>=}2, {>=}2.5, {>=}3, {>=}3.5 (SUV{sub n}); {>=}40%, {>=}45%, and {>=}50% of the maximum (SUV{sub n%}); and mean liver SUV + 1, 2, 3, and 4 standard deviations (SUV{sub Ln{sigma}}). The volume ratio and conformality index were determined between MTVs, and the corresponding CT/endoscopic ultrasound-based gross tumor volume (GTV) at the epicenter. Means were analyzed by one-way analysis of variance for repeated measures and further compared using a paired t test for repeated measures. Results: The mean conformality indices ranged from 0.33 to 0.48, being significantly (p < 0.05) closest to 1 at SUV{sub 2.5} (0.47 {+-} 0.03) and SUV{sub L4{sigma}} (0.48 {+-} 0.03). The mean volume ratios ranged from 0.39 to 2.82, being significantly closest to 1 at SUV{sub 2.5} (1.18 {+-} 0.36) and SUV{sub L4{sigma}} (1.09 {+-} 0.15). The mean value of the SUVs calculated using the SUV{sub L4{sigma}} approach was 2.4. Conclusions: Regardless of the SUV thresholding method used (i.e., absolute or relative to liver mean), a threshold of approximately 2.5 yields the highest conformality index and best approximates the CT-based GTV at the epicenter. These findings may ultimately aid radiation oncologists in the delineation of the entire GTV in esophageal cancer patients.

• OSTI ID: 21438040
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 78; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
EMISSION COMPUTED TOMOGRAPHY
ESOPHAGUS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PLANNING
POSITRON COMPUTED TOMOGRAPHY
RADIOLOGY
RADIOTHERAPY
THERAPY
TOMOGRAPHY
UPTAKE