The Impact of Positron Emission Tomography/Computed Tomography Addition to Contrast-Enhanced Computed Tomography Findings During Radiation Treatment Planning of Locally Advanced Carcinoma Esophagus

Overview

Journal J Med Phys

Date 2020 Jan 8

PMID 31908387

Authors

Sharad Bhatnagar

Shweta Sharma

Manoj Semwal

Sankalp Singh

Affiliations

Soon will be listed here.

Abstract

Introduction: Does metabolic imaging help in better definition of target during radiation treatment planning by bringing about changes in dimensions of the primary tumor in terms of diameter, length, and picking up new skip lesions or nodal stations which in turn prevents geographic misses by including more F-fluorodeoxyglucose avid regions not visible on conventional imaging?

Materials And Methods: We compared the length and radial dimensions of the primary tumor as well as changes brought about due to addition of new nodal stations, involved structures, and skip lesions in 50 patients of carcinoma esophagus treated between 2011 and 2013, as seen on contrast-enhanced computed tomography (CT) thorax and positron emission tomography (PET)/CT and drew conclusions regarding the technical changes brought about in treatment planning by the additional input of PET/CT.

Results And Conclusions: PET-CT tremendously changes treatment plans by expanding the gross tumor volume and including regions which might otherwise have been missed on purely CT-based plans. Of the 50 patients, it changed the contouring and treatment planning of 35 patients and did not impact the remaining 15. Whether this translates into better long-term controls requires further validation by randomized controlled trials, which was not our present objective.

References

Weiss E, Hess C . The impact of gross tumor volume (GTV) and clinical target volume (CTV) definition on the total accuracy in radiotherapy theoretical aspects and practical experiences. Strahlenther Onkol. 2003; 179(1):21-30. DOI: 10.1007/s00066-003-0976-5. View

Stahl A, Stollfuss J, Ott K, Wieder H, Fink U, Schwaiger M . FDG PET and CT in locally advanced adenocarcinomas of the distal oesophagus. Clinical relevance of a discordant PET finding. Nuklearmedizin. 2006; 44(6):249-55. View

Bar-Shalom R, Guralnik L, Tsalic M, Leiderman M, Frenkel A, Gaitini D . The additional value of PET/CT over PET in FDG imaging of oesophageal cancer. Eur J Nucl Med Mol Imaging. 2005; 32(8):918-24. DOI: 10.1007/s00259-005-1795-y. View

Yoon Y, Lee K, Shim Y, Kim B, Kim K, Kim T . Metastasis to regional lymph nodes in patients with esophageal squamous cell carcinoma: CT versus FDG PET for presurgical detection prospective study. Radiology. 2003; 227(3):764-70. DOI: 10.1148/radiol.2281020423. View

Kato H, Kuwano H, Nakajima M, Miyazaki T, Yoshikawa M, Ojima H . Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma. Cancer. 2002; 94(4):921-8. View

Moureau-Zabotto L, Touboul E, Lerouge D, Deniaud-Alexandre E, Grahek D, Foulquier J . Impact of CT and 18F-deoxyglucose positron emission tomography image fusion for conformal radiotherapy in esophageal carcinoma. Int J Radiat Oncol Biol Phys. 2005; 63(2):340-5. DOI: 10.1016/j.ijrobp.2005.02.039. View

FISCHER J, Moulder J . The steepness of the dose-response curve in radiation therapy. Theoretical considerations and experimental results. Radiology. 1975; 117(1):179-84. DOI: 10.1148/117.1.179. View

Vrieze O, Haustermans K, De Wever W, Lerut T, Van Cutsem E, Ectors N . Is there a role for FGD-PET in radiotherapy planning in esophageal carcinoma?. Radiother Oncol. 2004; 73(3):269-75. DOI: 10.1016/j.radonc.2004.10.001. View

Mohan R, Chui C, Miller D, Laughlin J . Use of computerized tomography in dose calculations for radiation treatment planning. J Comput Tomogr. 1981; 5(3):273-82. DOI: 10.1016/0149-936x(81)90043-6. View

10.

Schreurs L, Busz D, Paardekooper G, Beukema J, Jager P, van der Jagt E . Impact of 18-fluorodeoxyglucose positron emission tomography on computed tomography defined target volumes in radiation treatment planning of esophageal cancer: reduction in geographic misses with equal inter-observer variability: PET/CT improves.... Dis Esophagus. 2010; 23(6):493-501. DOI: 10.1111/j.1442-2050.2009.01044.x. View

11.

Tai P, Van Dyk J, Yu E, Battista J, Stitt L, Coad T . Variability of target volume delineation in cervical esophageal cancer. Int J Radiat Oncol Biol Phys. 1998; 42(2):277-88. DOI: 10.1016/s0360-3016(98)00216-8. View

12.

Flamen P, Lerut A, Van Cutsem E, De Wever W, Peeters M, Stroobants S . Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J Clin Oncol. 2000; 18(18):3202-10. DOI: 10.1200/JCO.2000.18.18.3202. View

13.

Leong T, Everitt C, Yuen K, Condron S, Hui A, Ngan S . A prospective study to evaluate the impact of FDG-PET on CT-based radiotherapy treatment planning for oesophageal cancer. Radiother Oncol. 2006; 78(3):254-61. DOI: 10.1016/j.radonc.2006.02.014. View

14.

Vesprini D, Ung Y, Dinniwell R, Breen S, Cheung F, Grabarz D . Improving observer variability in target delineation for gastro-oesophageal cancer--the role of (18F)fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography. Clin Oncol (R Coll Radiol). 2008; 20(8):631-8. DOI: 10.1016/j.clon.2008.06.004. View