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Current status of PET/CT for tumour volume definition in radiotherapy treatment planning for non-small cell lung cancer (NSCLC).
- Source :
-
Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2007 Aug; Vol. 57 (2), pp. 125-34. Date of Electronic Publication: 2007 May 02. - Publication Year :
- 2007
-
Abstract
- Target volume delineation of lung cancer is well known to be prone to large inter-observer variability. The advent of PET/CT devices, with co-registered functional and anatomical data, has opened new exciting possibilities for target volume definition in radiation oncology. PET/CT imaging is rapidly being embraced by the radiation oncology community as a tool to improve the accuracy of target volume delineation for treatment optimization in NSCLC. Several studies have dealt with the feasibility of incorporating FDG-PET information into contour delineation with the aim to improve overall accuracy and to reduce inter-observer variation. A significant impact of PET-derived contours on treatment planning has been shown in 30-60% of the plans with respect to the CT-only target volume. The most prominent changes in the gross tumour volume (GTV) have been reported in cases with atelectasis and following the incorporation of PET-positive nodes in otherwise CT-insignificant nodal areas. Although inter-observer variability is still present following target volume delineation with PET/CT, it is greatly reduced compared to conventional CT-only contouring. PET/CT may also provide improved therapeutic ratio compared to conventional CT planning. Increased target coverage and often reduced target volumes may potentially result in PET/CT-based planning to yield better tumour control probability through dose escalation, while still complying with dose/volume constrains for normal tissues. Despite these exciting results, more clinical studies need to be performed to better define the role of combined PET/CT in treatment planning for NSCLC.
- Subjects :
- Carcinoma, Non-Small-Cell Lung pathology
Carcinoma, Non-Small-Cell Lung radiotherapy
Dose-Response Relationship, Radiation
Fluorodeoxyglucose F18
Humans
Lung Neoplasms pathology
Lung Neoplasms radiotherapy
Observer Variation
Positron-Emission Tomography methods
Radiopharmaceuticals therapeutic use
Radiotherapy Dosage
Radiotherapy, Conformal
Tomography, X-Ray Computed methods
Tumor Burden
Carcinoma, Non-Small-Cell Lung diagnostic imaging
Lung Neoplasms diagnostic imaging
Positron-Emission Tomography trends
Tomography, X-Ray Computed trends
Subjects
Details
- Language :
- English
- ISSN :
- 0169-5002
- Volume :
- 57
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Lung cancer (Amsterdam, Netherlands)
- Publication Type :
- Academic Journal
- Accession number :
- 17478008
- Full Text :
- https://doi.org/10.1016/j.lungcan.2007.03.020