Impact of hybrid fluorodeoxyglucose positron-emission tomography/computed tomography on radiotherapy planning in esophageal and non-small-cell lung cancer

Vinai Gondi, Kristin Bradley, Minesh Mehta, Andy Howard, Deepak Khuntia, Mark Ritter, Wolfgang A. Tome

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Purpose: The aim of this study was to investigate the impact of a hybrid fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) scanner in radiotherapy planning for esophageal and non-small-cell lung cancer (NSCLC). Methods and Materials: A total of 30 patients (16 with esophageal cancer, 14 with NSCLC) underwent an FDG-PET/CT for radiotherapy planning purposes. Noncontrast total-body spiral CT scans were obtained first, followed immediately by FDG-PET imaging which was automatically co-registered to the CT scan. A physician not involved in the patients' original treatment planning designed a gross tumor volume (GTV) based first on the CT dataset alone, while blinded to the FDG-PET dataset. Afterward, the physician designed a GTV based on the fused PET/CT dataset. To standardize PET GTV margin definition, background liver PET activity was standardized in all images. The CT-based and PET/CT-based GTVs were then quantitatively compared by way of an index of conformality, which is the ratio of the intersection of the two GTVs to their union. Results: The mean index of conformality was 0.44 (range, 0.00-0.70) for patients with NSCLC and 0.46 (range, 0.13-0.80) for patients with esophageal cancer. In 10 of the 16 (62.5%) esophageal cancer patients, and in 12 of the 14 (85.7%) NSCLC patients, the addition of the FDG-PET data led to the definition of a smaller GTV. Conclusion: The incorporation of a hybrid FDG-PET/CT scanner had an impact on the radiotherapy planning of esophageal cancer and NSCLC. In future studies, we recommend adoption of a conformality index for a more comprehensive comparison of newer treatment planning imaging modalities to conventional options.

Original languageEnglish (US)
Pages (from-to)187-195
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume67
Issue number1
DOIs
StatePublished - Jan 1 2007
Externally publishedYes

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Non-Small Cell Lung Carcinoma
lungs
planning
radiation therapy
positrons
Radiotherapy
tomography
cancer
Esophageal Neoplasms
Tumor Burden
X-Ray Computed Tomography Scanners
tumors
physicians
Physicians
scanners
Spiral Computed Tomography
Positron Emission Tomography Computed Tomography
unions
liver
intersections

Keywords

  • Computed tomography
  • Esophageal cancer
  • Non-small-cell lung cancer
  • Positron emission tomography
  • Radiotherapy planning

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Impact of hybrid fluorodeoxyglucose positron-emission tomography/computed tomography on radiotherapy planning in esophageal and non-small-cell lung cancer. / Gondi, Vinai; Bradley, Kristin; Mehta, Minesh; Howard, Andy; Khuntia, Deepak; Ritter, Mark; Tome, Wolfgang A.

In: International Journal of Radiation Oncology Biology Physics, Vol. 67, No. 1, 01.01.2007, p. 187-195.

Research output: Contribution to journalArticle

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abstract = "Purpose: The aim of this study was to investigate the impact of a hybrid fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) scanner in radiotherapy planning for esophageal and non-small-cell lung cancer (NSCLC). Methods and Materials: A total of 30 patients (16 with esophageal cancer, 14 with NSCLC) underwent an FDG-PET/CT for radiotherapy planning purposes. Noncontrast total-body spiral CT scans were obtained first, followed immediately by FDG-PET imaging which was automatically co-registered to the CT scan. A physician not involved in the patients' original treatment planning designed a gross tumor volume (GTV) based first on the CT dataset alone, while blinded to the FDG-PET dataset. Afterward, the physician designed a GTV based on the fused PET/CT dataset. To standardize PET GTV margin definition, background liver PET activity was standardized in all images. The CT-based and PET/CT-based GTVs were then quantitatively compared by way of an index of conformality, which is the ratio of the intersection of the two GTVs to their union. Results: The mean index of conformality was 0.44 (range, 0.00-0.70) for patients with NSCLC and 0.46 (range, 0.13-0.80) for patients with esophageal cancer. In 10 of the 16 (62.5{\%}) esophageal cancer patients, and in 12 of the 14 (85.7{\%}) NSCLC patients, the addition of the FDG-PET data led to the definition of a smaller GTV. Conclusion: The incorporation of a hybrid FDG-PET/CT scanner had an impact on the radiotherapy planning of esophageal cancer and NSCLC. In future studies, we recommend adoption of a conformality index for a more comprehensive comparison of newer treatment planning imaging modalities to conventional options.",
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AU - Khuntia, Deepak

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