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Evaluation of the role of 18FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer

Abstract

Background and purpose. As techniques for radiotherapy delivery have developed, increasingly accurate localisation of disease is demanded. Functional imaging, particularly PET and its fusion with anatomical modalities, such as PET/CT, promises to improve detection and characterisation of disease. This study evaluated the impact of 18FDG-PET/CT on radiotherapy target volume definition in head and neck cancer (HNC). Materials and methods. The PET/CT scans of patients with HNC were used in a radiotherapy planning (RTP) study. The gross tumour volume (GTV), clinical target volume (CTV) and planning target volume (PTV) were defined conventionally and compared to those defined using the PET/CT. Data were reported as the median value with 95% confidence intervals. Results. Eighteen patients were consented, 9 had known primary tumour site, 9 presented as unknown primary. In nine cases where the primary site was known, the combined primary and nodal GTV (GTVp+n) increased by a median of 6.1cm3 (2.6, 12.2) or 78% (18, 313), p=0.008 with CTV increasing by a median of 10.1cm3 (1.3, 30.6) or 4% (0, 13) p=0.012. In 9 cases of unknown primary the GTVp+n increased by a median 6.3cm3 (0.2, 15.7) or 61% (4, 210), p=0.012, with CTV increasing by a median 155.4cm3 (2.7, 281.7) or  More>>
Authors:
Newbold, Katie L; Partridge, Mike; Cook, Gary; Sharma, Bhupinder; Rhys-Evans, Peter; Harrington, Kevin J; Nutting, Christopher M [1] 
  1. The Royal Marsden NHS Foundation Trust, Sutton, Surrey (United Kingdom)
Publication Date:
Aug 15, 2008
Product Type:
Journal Article
Resource Relation:
Journal Name: Acta Oncologica (Stockholm) (online); Journal Volume: 47; Journal Issue: 7; Other Information: 24 refs.; 10.1080/02841860802256483
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; FLUORODEOXYGLUCOSE; FLUORINE 18; CT-GUIDED RADIOTHERAPY; NMR IMAGING; HEAD; NECK; NEOPLASMS; POSITRON COMPUTED TOMOGRAPHY
OSTI ID:
939823
Country of Origin:
Sweden
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1651-226X; TRN: SE0808348
Availability:
Available from DOI: http://dx.doi.org/10.1080/02841860802256483
Submitting Site:
SWDN
Size:
page(s) 1229-1236
Announcement Date:
Oct 27, 2008

Citation Formats

Newbold, Katie L, Partridge, Mike, Cook, Gary, Sharma, Bhupinder, Rhys-Evans, Peter, Harrington, Kevin J, and Nutting, Christopher M. Evaluation of the role of 18FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer. Sweden: N. p., 2008. Web. doi:10.1080/02841860802256483.
Newbold, Katie L, Partridge, Mike, Cook, Gary, Sharma, Bhupinder, Rhys-Evans, Peter, Harrington, Kevin J, & Nutting, Christopher M. Evaluation of the role of 18FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer. Sweden. https://doi.org/10.1080/02841860802256483
Newbold, Katie L, Partridge, Mike, Cook, Gary, Sharma, Bhupinder, Rhys-Evans, Peter, Harrington, Kevin J, and Nutting, Christopher M. 2008. "Evaluation of the role of 18FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer." Sweden. https://doi.org/10.1080/02841860802256483.
@misc{etde_939823,
title = {Evaluation of the role of 18FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer}
author = {Newbold, Katie L, Partridge, Mike, Cook, Gary, Sharma, Bhupinder, Rhys-Evans, Peter, Harrington, Kevin J, and Nutting, Christopher M}
abstractNote = {Background and purpose. As techniques for radiotherapy delivery have developed, increasingly accurate localisation of disease is demanded. Functional imaging, particularly PET and its fusion with anatomical modalities, such as PET/CT, promises to improve detection and characterisation of disease. This study evaluated the impact of 18FDG-PET/CT on radiotherapy target volume definition in head and neck cancer (HNC). Materials and methods. The PET/CT scans of patients with HNC were used in a radiotherapy planning (RTP) study. The gross tumour volume (GTV), clinical target volume (CTV) and planning target volume (PTV) were defined conventionally and compared to those defined using the PET/CT. Data were reported as the median value with 95% confidence intervals. Results. Eighteen patients were consented, 9 had known primary tumour site, 9 presented as unknown primary. In nine cases where the primary site was known, the combined primary and nodal GTV (GTVp+n) increased by a median of 6.1cm3 (2.6, 12.2) or 78% (18, 313), p=0.008 with CTV increasing by a median of 10.1cm3 (1.3, 30.6) or 4% (0, 13) p=0.012. In 9 cases of unknown primary the GTVp+n increased by a median 6.3cm3 (0.2, 15.7) or 61% (4, 210), p=0.012, with CTV increasing by a median 155.4cm3 (2.7, 281.7) or 95% (1, 137), p=0.008. Conclusion. 18FDG-PET revealed disease lying outside the conventional target volume, either extending a known area or highlighting a previously unknown area of disease, including the primary tumour in 5 cases. We recommend PET/CT in the RTP of all cases of unknown primary. In patients with a known primary, although the change in volume was statistically significant the clinical impact is less clear. 18FDG-PET can also show areas within the conventional target volume that are hypermetabolic which may be possible biological target volumes for dose escalation studies in the future}
doi = {10.1080/02841860802256483}
journal = []
issue = {7}
volume = {47}
place = {Sweden}
year = {2008}
month = {Aug}
}