PET Imaging During Radiotherapy of Head and Neck Cancer (original) (raw)
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International Journal of Radiation Oncology*Biology*Physics, 2009
Purpose: To evaluate the effect of the use of 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/ computed tomography (CT) in radiotherapy target delineation for head-and-neck cancer compared with CT alone. Methods and Materials: A total of 38 consecutive patients with head-and-neck cancer were included in this study. The primary tumor sites were as follow: 20 oropharyngeal tumors, 4 laryngeal tumors, 2 hypopharyngeal tumors, 2 paranasal sinuses tumors, 9 nasopharyngeal tumors, and 1 parotid gland tumor. The FDG-PET and CT scans were performed with a dedicated PET/CT scanner in one session and then fused. Subsequently, patients underwent treatment planning CT with intravenous contrast enhancement. The radiation oncologist defined all gross tumor volumes (GTVs) using both the PET/CT and CT scans. Results: In 35 (92%) of 38 cases, the CT-based GTVs were larger than the PET/CT-based GTVs. The average total GTV from the CT and PET/CT scans was 34.54 cm 3 (range, 3.56-109) and 29.38 cm 3 (range, 2.87-95.02), respectively (p < 0.05). Separate analyses of the difference between the CT-and PET/CT-based GTVs of the primary tumor compared with the GTVs of nodal disease were not statistically significant. The comparison between the PET/ CT-based and CT-based boost planning target volumes did not show a statistically significant difference. All patients were alive at the end of the follow-up period (range, 3-38 months). Conclusion: GTVs, but not planning target volumes, were significantly changed by the implementation of combined PET/CT. Large multicenter studies are needed to ascertain whether combined PET/CT in target delineation can influence the main clinical outcomes. Ó
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2007
Our purpose was to prospectively evaluate the efficacy of PET with (18)F-FDG 1 mo after the completion of radiotherapy in patients with squamous cell carcinoma of the head and neck (SCCHN). Ninety-seven patients underwent (18)F-FDG PET scans before and after radiotherapy for nondisseminated SCCHN. The first scans were obtained no more than 4 wk before the start of radiotherapy, and follow-up scans were obtained 1 mo after the completion of radiotherapy. (18)F-FDG PET images were analyzed using standardized uptake values (SUVs). All patients were followed for at least 6 mo or until death. The median SUVs of preradiotherapy primary sites and nodes were 6.5 (range, 2.3-23.0) and 5.6 (range, 1.2-16.8), respectively. The median SUVs of postradiotherapy primary sites and nodes were 1.8 (range, basal status value to 9.7) and 1.8 (range, basal status value to 8.6), respectively. Evaluation of the postradiotherapy status of tumors in these SCCHN patients showed the sensitivity of (18)F-FDG P...
Asian Pacific journal of cancer prevention : APJCP, 2014
In this study, we aimed to investigate the benefits of 18F-deoxyglucose positron emission tomography/computed tomography (FGD-PET/CT) imaging for staging and radiotherapy planning in patients with head and neck cancer undergoing definitive radiotherapy. Thirty-seven head and neck cancer patients who had undergone definitive radiotherapy and PET/CT at the Uludag University Medical Faculty Department of Radiation Oncology were investigated in order to determine the role of PET/CT in staging and radiotherapy planning. The median age of this patient group of 32 males and 5 females was 57 years (13-84years). The stage remained the same in 18 cases, decreased in 5 cases and increased in 14 cases with PET/CT imaging. Total gross tumor volume (GTV) determined by CT (GTVCT-Total) was increased in 32 cases (86.5%) when compared to total GTV determined by PET/CT (GTVPET/CT-Total). The GTV of the primary tumor determined by PET/CT (GTVPET/CT) was larger in 3 cases and smaller in 34 cases compar...
World journal of nuclear medicine, 2014
18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has become increasingly relevant in the staging of head and neck cancers, but its prognostic value is controversial. The objective of this study was to evaluate different PET/CT parameters for their ability to predict response to therapy and survival in patients treated for head and neck cancer. A total of 28 consecutive patients with a variety of newly diagnosed head and neck cancers underwent PET/CT scanning at our institution before initiating definitive radiation therapy. All underwent a posttreatment PET/CT to gauge tumor response. Pretreatment PET/ CT parameters calculated include the standardized uptake value (SUV) and the anatomical biological value (ABV), which is the product of SUV and greatest tumor diameter. Maximum and mean values were studied for both SUV and ABV, and correlated with response rate and survival. The mean pretreatment tumor ABV max decreased from 35.5 to 7.9 (P = 0.0001). Of the parameters tested, only pretreatment ABV max was significantly different among those patients with a complete response (CR) and incomplete response (22.8 vs. 65, respectively, P = 0.021). This difference was maximized at a cutoff ABV max of 30 and those patients with ABV max < 30 were significantly more likely to have a CR compared to those with ABV max of ≥ 30 (93.8% vs. 50%, respectively, P = 0.023). The 5-year overall survival was 80% compared to 36%, respectively, (P = 0.028). Multivariate analysis confirmed that ABV max was an independent prognostic factor. Our data supports the use of PET/CT, and specifically ABV max , as a prognostic factor in head and neck cancer. Patients who have an ABV max ≥ 30 were more likely to have a poor outcome with chemoradiation alone, and a more aggressive trimodality approach may be indicated in these patients.
Head & Neck, 2009
BackgroundThe use of a single MRI and 18F‐fluoro deoxyglucose positron emission tomography‐CT (18F‐FDG PET‐CT) was evaluated, both in diagnostic procedure and radiotherapy planning, in patients with head and neck cancer.MethodsThirty‐five patients with nasopharyngeal and oropharyngeal tumors were studied. The MRI and 18F‐FDG PET‐CT were used for both diagnostic work‐up and gross tumor volume and critical structure delineation. The interobserver variation (IOV) of volumes determined on MRI and CT by a radiotherapist and by a radiologist were compared as well as their impact on dose distribution.ResultsThe CT‐MRI decreased the IOV of parotid glands in 12 of 35 and target volume in 15 of 35 patients. The use of 18F‐FDG PET‐CT changed the treatment design in 6 of 21 patients.ConclusionsDiagnostic imaging performed in the treatment position can improve the accuracy of radiotherapy planning in case of intracranial tumor extension, heavy dental work, or contraindication for contrast‐enhanc...