PET/CT-guided treatment planning for paediatric cancer patients: A simulation study of proton and conventional photon therapy

Josefine Ståhl Kornerup, Nils P. Brodin, T. Björk-Eriksson, C. Birk Christensen, A. Kiil-Berthelsen, M. C. Aznar, C. Hollensen, E. Markova, P. Munck Af Rosenschöld

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT-and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT.

Original languageEnglish (US)
Article number20140586
JournalBritish Journal of Radiology
Volume88
Issue number1047
DOIs
StatePublished - Mar 1 2015

Fingerprint

Patient Simulation
Photons
Positron-Emission Tomography
Protons
Pediatrics
Radiotherapy
Fluorodeoxyglucose F18
Neoplasms
Proton Therapy
Therapeutics
Conformal Radiotherapy
Fluorine
Morbidity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Kornerup, J. S., Brodin, N. P., Björk-Eriksson, T., Birk Christensen, C., Kiil-Berthelsen, A., Aznar, M. C., ... Munck Af Rosenschöld, P. (2015). PET/CT-guided treatment planning for paediatric cancer patients: A simulation study of proton and conventional photon therapy. British Journal of Radiology, 88(1047), [20140586]. https://doi.org/10.1259/bjr.20140586

PET/CT-guided treatment planning for paediatric cancer patients : A simulation study of proton and conventional photon therapy. / Kornerup, Josefine Ståhl; Brodin, Nils P.; Björk-Eriksson, T.; Birk Christensen, C.; Kiil-Berthelsen, A.; Aznar, M. C.; Hollensen, C.; Markova, E.; Munck Af Rosenschöld, P.

In: British Journal of Radiology, Vol. 88, No. 1047, 20140586, 01.03.2015.

Research output: Contribution to journalArticle

Kornerup, JS, Brodin, NP, Björk-Eriksson, T, Birk Christensen, C, Kiil-Berthelsen, A, Aznar, MC, Hollensen, C, Markova, E & Munck Af Rosenschöld, P 2015, 'PET/CT-guided treatment planning for paediatric cancer patients: A simulation study of proton and conventional photon therapy', British Journal of Radiology, vol. 88, no. 1047, 20140586. https://doi.org/10.1259/bjr.20140586
Kornerup, Josefine Ståhl ; Brodin, Nils P. ; Björk-Eriksson, T. ; Birk Christensen, C. ; Kiil-Berthelsen, A. ; Aznar, M. C. ; Hollensen, C. ; Markova, E. ; Munck Af Rosenschöld, P. / PET/CT-guided treatment planning for paediatric cancer patients : A simulation study of proton and conventional photon therapy. In: British Journal of Radiology. 2015 ; Vol. 88, No. 1047.
@article{93ca74ae1c4a4accbb24e6e7c078d584,
title = "PET/CT-guided treatment planning for paediatric cancer patients: A simulation study of proton and conventional photon therapy",
abstract = "Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT-and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT.",
author = "Kornerup, {Josefine St{\aa}hl} and Brodin, {Nils P.} and T. Bj{\"o}rk-Eriksson and {Birk Christensen}, C. and A. Kiil-Berthelsen and Aznar, {M. C.} and C. Hollensen and E. Markova and {Munck Af Rosensch{\"o}ld}, P.",
year = "2015",
month = "3",
day = "1",
doi = "10.1259/bjr.20140586",
language = "English (US)",
volume = "88",
journal = "British Journal of Radiology",
issn = "0007-1285",
publisher = "British Institute of Radiology",
number = "1047",

}

TY - JOUR

T1 - PET/CT-guided treatment planning for paediatric cancer patients

T2 - A simulation study of proton and conventional photon therapy

AU - Kornerup, Josefine Ståhl

AU - Brodin, Nils P.

AU - Björk-Eriksson, T.

AU - Birk Christensen, C.

AU - Kiil-Berthelsen, A.

AU - Aznar, M. C.

AU - Hollensen, C.

AU - Markova, E.

AU - Munck Af Rosenschöld, P.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT-and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT.

AB - Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT-and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT.

UR - http://www.scopus.com/inward/record.url?scp=84923480339&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923480339&partnerID=8YFLogxK

U2 - 10.1259/bjr.20140586

DO - 10.1259/bjr.20140586

M3 - Article

C2 - 25494657

AN - SCOPUS:84923480339

VL - 88

JO - British Journal of Radiology

JF - British Journal of Radiology

SN - 0007-1285

IS - 1047

M1 - 20140586

ER -