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Volumetric and dosimetric comparison of computerised radiotherapy treatment plan between using positron emission tomography/computed tomography (PET/CT) and CT images for target delineation in non-small cell lung cancer patients

Published online by Cambridge University Press:  18 April 2016

Sanphat Sangudsup ,
Tawika Kaewchur ,
Waralee Teeyasoontranon ,
Pitchayaponne Klunklin ,
Nisa Chawapun  and
Supoj Ua-apisitwong
Sanphat Sangudsup
Affiliation:
Medical Physics Master Degree Program, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Tawika Kaewchur
Affiliation:
Department of Radiology, Division of Nuclear Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Waralee Teeyasoontranon
Affiliation:
Department of Radiology, Division of Nuclear Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Pitchayaponne Klunklin
Affiliation:
Division of Therapeutic Radiology and Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Nisa Chawapun
Affiliation:
Division of Therapeutic Radiology and Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Supoj Ua-apisitwong*
Affiliation:
Department of Radiology, Division of Nuclear Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
*
Correspondence to: Supoj Ua-apisitwong, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, 239 Huay Kaew Road, Muang District, Chiang Mai, Thailand, 50200. Tel: +66 83 5668983. E-mail: apisitwong_sp@yahoo.com
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Abstract

Purpose

To compare intensity-modulated radiation therapy (IMRT) treatment planning between using positron emission tomography/computed tomography (PET/CT) and CT for target volume delineation in patients with non-small cell lung cancer (NSCLC).

Methods

Nine NSCLC patients with PET/CT images were enrolled into this study. Gross tumour volumes (GTVs) were delineated by the PET visual assessment (PETvis), the automated PET (PETauto), standardised uptake value (SUV)>2·5 (PET2·5) and threshold 40% SUVmax (PET40), and CT-based method. For each patient, two IMRT treatment plans based on CT and PET/CT delineation were performed. The target coverage and the dose–volume parameters for organs at risk were analysed.

Results

The PETauto referred to PET40 when SUVmax<7 and PET2·5 when SUVmax≥7. The mean GTVs were 15·04, 15·7 and 15·14 cc for PETauto, PETvis and CT based, respectively. The GTV of PETauto was not different from PETvis (p=0·441) and CT based (p=0·594). Based on CT delineation in IMRT planning, only 34% of the cases had sufficient PET/CT planning target volumes coverage, whereas the organs at risk dose parameters were not statistically significant (p>0·05).

Conclusions

PET/CT enables more accurate assessment of tumour delineation for NSCLC, therefore improve target coverage in IMRT plan.

Keywords

intensity-modulated radiation therapy (IMRT)non-small cell lung cancer (NSCLC)positron emission tomography/computed tomography (PET/CT)standardised uptake value (SUV)target volume delineation
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 2 , June 2016 , pp. 161 - 169
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Copyright
© Cambridge University Press 2016 

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References

1.Van de Steene, J, Linthout, N, De Mey, Jet al. Definition of gross tumor volume in lung cancer: inter-observer variability. Radiother Oncol 2002; 62: 37–49.Google Scholar
2.Seeram, E. Physical Principles of Computed Tomography, 2nd edition. PA: W.B. Saunders company, Philadelphia, USA, 2001.Google Scholar
3.Zhang, QN, Wang, DY, Wang, XHet al. Nonconventional radiotherapy versus conventional radiotherapy for inoperable non-small-cell lung cancer: a meta-analysis of randomized clinical trials. Thorac Cancer 2012; 3: 269–279.Google Scholar
4.Zhang, ZJ. Technical capacity and clinical application of PET/CT. Chin Med Equipm J 2007; 28: 59–60.Google Scholar
5.Chuhr, KJH, Kim, JH, Yoon, DYet al. Additional diagnostic value of (18)F-FDG PET-CT in detecting retropharyngeal nodal metastases. Otolaryngol Head Neck Surg 2009; 141: 633–638.Google Scholar
6.Kang, BJ, JH, O, Baik, JHet al. Incidental thyroid uptake on F-18 FDG PET/CT: correlation with ultrasonography and pathology. Ann Nucl Med 2009; 23: 729–737.Google Scholar
7.Vansteenkiste, J, Fischer, BM, Dooms, Cet al. Positron-emission tomography in prognostic and therapeutic assessment of lung cancer: systematic review. Lancet Oncol 2004; 5: 531–540.Google Scholar
8.Hong, R, Halama, J, Bova, Det al. Correlation of PET standard uptake value and CT window-level thresholds for target delineation in CT-based radiation treatment planning. Int J Radiat Oncol Biol Phys 2007; 67: 720–726.Google Scholar
9.Hoseok, I, Kim, K, Kim, SJet al. Prognostic value of metabolic volume measured by F-18 FDG PET-CT in patients with esophageal cancer. Thorac Cancer 2012; 3: 255–261.Google Scholar
10.Wang, DQ, Chen, JH, Li, BSet al. Influence of FDG PET-CT on the target region and planning of precise and accurate radiotherapy for local advanced non-small cell lung cancer. Chin J Radiat Oncol 2011; 20: 172–173.Google Scholar
11.Huang, S. Anatomy of SUV standardized uptake value. Nucl Med Biol 2000; 27: 643–646.Google Scholar
12.Vansteenkiste, J, Stroobants, S, Dupont, Pet al. Prognostic importance of the standardized uptake value on FDG PET in NSCLC: an analysis of 125 cases. J Clin Oncol 1999; 17: 3201–3206.CrossRefGoogle ScholarPubMed
13.Erdi, Y, Rosenzweig, K, Erdi, Aet al. Radiotherapy treatment planning for patients with NSCLC using PET. Radiother Oncol 2002; 62: 51–60.CrossRefGoogle ScholarPubMed
14.Menzel, HG, Wambersie, A, Jones, DTLet al. The ICRU report 83: prescribing, recording, and reporting photon-beam intensity-modulated radiation therapy (IMRT). J ICRU 2010; 10: 55–59.Google Scholar
15.Graham, MV, Purdy, JA, Enami, BEet al. Clinical dose volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys 1999; 45: 323–329.Google Scholar
16.Kwa, SL, Lebesque, JV, Theuws, JCet al. Radiation pneumonitis as a function of mean lung dose: an analysis of pooled data from 540 patients. Int J Radiat Oncol Biol Phys 1998; 42: 1–9.Google Scholar
17.Hirota, S, Tsujino, K, Endo, Met al. Dosimetric predictors of radiation esophagitis in patients treated for non-small lung cancer with carboplatin/paclitaxel/radiotherapy. Int J Radiat Oncol Biol Phys 2001; 51: 291–295.Google Scholar
18.Werner-Wasik, M, Pequignot, E, Leeper, Det al. Predictors of severe esophagitis include use of concurrent chemotherapy, but not the length of irradiated esophagus: a multivariate analysis of patients with lung cancer treated with nonoperative therapy. Int J Radiat Oncol Biol Phys 2000; 48: 689–696.Google Scholar
19.Rogerio, L, Michael, S, Michele, TNet al. A phase II trial of combined modality therapy with growth factor support for patients with limited stage small cell lung cancer. J Thorac Oncol 2010; 5: 837–840.Google Scholar
20.Kirby, AM, Yarnold, JR, Evans, PMet al. Tumor bed delineation for partial breast and breast boost radiotherapy planned in the prone position: what does MRI add to X-ray CT localization of titanium clips placed in the excision cavity wall? Int J Radiat Oncol Biol Phys 2009; 74: 1276–1282.Google Scholar
21.Yin, LJ, Yu, XB, Ren, YGet al. Utilization of PET-CT in target volume delineation for three-dimensional conformal radiotherapy in patients with non-small cell lung cancer and atelectasis. Multidiscip Respir Med 2013; 8: 21.CrossRefGoogle ScholarPubMed
22.Musolino, SV. Absorbed dose determination in external beam radiotherapy: an international code of practice for dosimetry based on standards of absorbed dose to water. Technical Reports Series No. 398 (LWW, 2001), Vienna, Austria, 2000.CrossRefGoogle Scholar
23.Deniaud-Alexandre, E, Touboul, E, Lerouge, Det al. Impact of computed tomography and 18Fdeoxyglucose coincidence detection emission tomography image fusion for optimization of conformal radiotherapy in non-small cell lung cancer. Int J Radiat Oncol Biol Phys 2005; 63: 1432–1441.Google Scholar
24.Bradley, J, Thorstad, W, Mutic, Set al. Impact of FDG-PET on radiation therapy volume delineation in NSCLC. Int J Radiat Oncol Biol Phys 2004; 59: 78–86.Google Scholar