Dose-painted Volumetric Modulated Arc Therapy of High-grade Glioma Using 3,4-dihydroxy-6-[F]fluoro-L-phenylalanine Positron Emission Tomography

Overview

Journal Br J Radiol

Publisher Oxford University Press

Specialty Radiology

Date 2019 Apr 25

PMID 31017449

Citations 6

Authors

Robert Kosztyla

Srinivas Raman

Vitali Moiseenko

Stefan A Reinsberg

Brian Toyota

Alan Nichol

Affiliations

Soon will be listed here.

Abstract

Objective: To determine whether dose painting with volumetric modulated arc therapy for high-grade gliomas using 3,4-dihydroxy-6-[F]fluoro-l-phenylalanine (F-FDOPA) positron emission tomography (PET) could achieve dose-escalated coverage of biological target volumes (BTVs) without increasing the dose to cranial organs at risk (OARs).

Methods: 10 patients with high-grade gliomas underwent CT, MRI, and F-FDOPA PET/CT images for post-operative radiation therapy planning. Two volumetric modulated arc therapy plans were retrospectively generated for each patient: a conventional plan with 60 Gy in 30 fractions to the planning target volume delineated on MRI and a dose-escalated plan with a maximum dose of 80 Gy in 30 fractions to BTVs. BTVs were created by thresholding F-FDOPA PET/CT uptake using a linear quadratic model that assumed tracer uptake was linearly related to tumour cell density. The maximum doses and equivalent uniform doses of OARs were compared.

Results: The median volume of the planning target volume receiving at least 95% of the prescribed dose ( ) was 99.6% with and 99.5% without dose painting. The median was >99.2% for BTVs. The maximum doses and equivalent uniform doses to the OARs did not differ significantly between the conventional and dose-painted plans.

Conclusion: Using commercially available treatment planning software, dose painting for high-grade gliomas was feasible with good BTV coverage and no significant change in the dose to OARs.

Advances In Knowledge: A novel treatment planning strategy was used to achieve dose painting for gliomas with BTVs obtained from F-FDOPA PET/CT using a radiobiological model.

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