Comparison of Standardized Uptake Value-Based Positron Emission Tomography and Computed Tomography Target Volumes in Esophageal Cancer Patients Undergoing Radiotherapy
- Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL (United States)
- Department of Preventive Medicine and Epidemiology, Loyola University Medical Center, Maywood, IL (United States)
- Department of Radiology, Section of Nuclear Medicine, Orlando VA Medical Center, Orlando, FL (United States)
- Department of Radiation Oncology, Virginia Hospital Center, Arlington, VA (United States)
- 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, Vol. 78, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2009.09.022; PII: S0360-3016(09)03216-7; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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