1. Influence of FDG-PET on computed tomography-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma.
- Author
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Zheng XK, Chen LH, Wang QS, Wu HB, Wang HM, Chen YQ, Yan WP, Li QS, and Xu YK
- Subjects
- Adult, Aged, Cyclic N-Oxides, Female, Humans, Male, Mercaptoethanol analogs & derivatives, Middle Aged, Nasopharyngeal Neoplasms diagnostic imaging, Neoplasm Recurrence, Local diagnostic imaging, Positron-Emission Tomography methods, Prospective Studies, Radiotherapy, Conformal methods, Tomography, X-Ray Computed methods, Fluorodeoxyglucose F18, Nasopharyngeal Neoplasms radiotherapy, Neoplasm Recurrence, Local radiotherapy, Radiopharmaceuticals, Radiotherapy Planning, Computer-Assisted methods
- Abstract
Purpose: Assuming F-18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET)/computed tomography (CT) to be more accurate in representing the true disease extent than CT alone, we prospectively designed this study to evaluate how the addition of FDG-PET influences CT-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma., Patients and Methods: All patients underwent FDG-PET/CT simulation scans. For each patient, the gross tumor volume (GTV) was separately delineated with or without the addition of PET information and defined as GTV PET/CT and GTV CT, respectively. Corresponding planning target volumes (PTV) were generated for the GTV CT (PTV(CT)) and GTV PET/CT (PTV PET/CT). Three-dimensional conformal radiotherapy plans were separately created for PTV CT and PTV PET/CT. To assess the potential geographic miss of the PET/CT-based disease in CT-based treatment planning, the size and location of the GTV PET/CT, PTV(PET/CT), and PTV(CT) were analyzed, and the three-dimensional conformal radiotherapy plans created using the PTV CT were evaluated with the GTV PET/CT and PTV PET/CT information., Results: A total of 43 patients were enrolled in this study. Distant metastasis was found in 4 patients with the addition of the PET information. The 39 patients without distant metastasis proceeded to three-dimensional conformal radiotherapy planning. Inadequate coverage of the GTV PET/CT and PTV PET/CT by the PTV CT occurred in 7 (18%) and 20 (51%) patients, respectively. This resulted in <95% of the GTV(PET/CT) and PTV PET/CT receiving >or=95% of the prescribed dose in 4 (10%) and 13 (33%) patients, respectively., Conclusions: The addition of FDG-PET information might influence CT-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma by altering the definition of the target volume, with the potential to avoid a geographic miss of true disease.
- Published
- 2007
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