Abstract
In the era of image-guided radiation therapy, treatment plans require narrower tumor margins and more attention dedicated to the location and configuration of tumor for better outcomes. Traditional anatomy-based modalities such as plain radiographs, computed tomography (CT), sonography, and magnetic resonance imaging (MRI) that yield high spatial resolution and accurate anatomic localization, are essential for radiation therapy planning, but may significantly under- or overestimate the extent of the disease. Advances in medical imaging, such as portal imaging, ultrasound, cone-beam CT, positron emission tomography (PET), MRI, and new software and hardware systems demonstrate accurate staging, planning, and delivery in radiation therapy with high geometric precision. Functional imaging such as single-photon emission computed tomography, PET/CT, and magnetic resonance spectroscopy that permit the visualization of the biologic pathways of tumors, are being incorporated into the algorithm for the workup, management, and evaluation of treatment effects in the radiation oncology practice. PET/CT could provide biologic imaging information and modify the clinical staging and target definition from the anatomic imaging. In addition to the concept of gross tumor volume, clinical and planning target volume, biologic target volume and dose painting were introduced (Schinagl et al. Cancer Imaging 6:S107–16, 2006; Grosu et al. Onkol 181:483–99, 2005; Nestle et al. Phys Med Biol 54:R1–25, 2009). This chapter will focus on the role of PET/CT in the staging (sensitivity and specificity), target volume definition, and possible assessment of response to radiation treatment. Future possibilities of new radiotracers to evaluate hypoxia, and proliferation, etc. will be discussed.
Keywords
- Positron Emission Tomography
- Planning Target Volume
- Epidermal Growth Factor Receptor Expression
- Target Volume Definition
- Dose Painting
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Schinagl DAX, Kaanders JHAM, Oyen WJG. From anatomical to biological target volumes: the role of PET in radiation treatment planning. Cancer Imaging. 2006;6:S107–16.
Grosu AL, Piert M, Weber WA, Jeremic B, Picchio M, Schratzenstaller U, Zimmermann FB, Schwaiger M, Molls M. Positron emission tomography for radiation treatment planning. Strahlenther Onkol. 2005;181:483–99.
Nestle U, Weber W, Hentscheland M, Grosu AL. Biological imaging in radiation therapy: role of positron emission tomography. Phys Med Biol. 2009;54:R1–25.
Heron DE, Andrade RS, Beriwal S, Smith RP. PET-CT in radiation oncology the impact on diagnosis, treatment planning, and assessment of treatment response. Am J Clin Oncol. 2008;31:352–62.
Troost EGC, Schinagl DAX, Bussink J, Boerman OC, van der Kogel AJ, Oyen WJG, Kaanders JHAM. Innovations in radiotherapy planning of head and neck cancers: role of PET. J Nucl Med. 2010;51:66–76.
Madani I, Duthoy W, Derie C, et al. Positron emission tomography-guided, focal dose escalation using intensity-modulated radiotherapy for head and neck cancer. Int J Radiation Oncol Biol Phys. 2007;68(1):126–35.
Vogel WV, Schinagl DAX, van Dalen JA, Kaanders JHAM, Oyen WJG. Validated image fusion of dedicated PET and CT for external beam radiation therapy in the head and neck area. Q J Nucl Med Mol Imaging. 2008;52:74–83.
Duprez F, de Neve W, de Gersem W Jr, Lic MC, Madani I. Adaptive dose painting by numbers for head-and-neck cancer. Int J Radation Oncol Biol Phys. 2010 (in press).
Grgic A, Nestle U, Schaefer-Schuler A, Kremp S, Kirsch CM, Hellwig D. FDG-PET–based radiotherapy planning in lung cancer: optimum breathing protocol and patient positioning—an individual comparison. Int J Radiation Oncol Biol Phys. 2009;73(1):103–11.
Sura S, Greco C, Gelblum D, Yorke ED, Jackson A, Rosenzweig K. 18F-fluorodeoxyglucose positron emission tomography-based assessment of local failure patterns in non-small-cell lung cancer treated with definitive radiotherapy. Int J Radiation Oncol Biol Phys. 2008;70(5):1397–402.
Kolodziejczyk M, Kepka L, Dziuk M, Anna Zawadzka A, Szalus N, Gizewska A, Bujko K. Impact of [18F]fluorodeoxyglucose PET-CT staging on treatment planning in radiotherapy incorporating elective nodal irradiation for non-small-cell lung cancer: a prospective study. Int J Radation Oncol Biol Phys. 2010 (in press).
Okubo M, Nishimura Y, Nakamatsu K, Okumura M, Shibata T, Kanamori S, Hanaoka K, Hosono M. Radiation treatment planning using positron emission and computed tomography for lung and pharyngeal cancers: a multiple-threshold method for [18F]fluoro-2-deoxyglucose activity. Int J Radiation Oncol Biol Phys. 2010;77(2):350–6.
Muijs CT, Beukema JC, Pruim J, Mul VE, Groen H, Plukker JT, Langendijk JA. A systematic review on the role of FDG-PET/CT in tumour delineation and radiotherapy planning in patients with esophageal cancer. Radiother Oncol. 2010;97(2):165–71.
Safar V, Dupuis J, Litti E, et al. Interim [18F]fluorodeoxyglucose positron emission tomography scan in diffuse large B-cell lymphoma treated with anthracycline-based chemotherapy plus rituximab. J Clin Oncol. 2012;30(2):184–90.
Itti E, Lin C, Dupuis et al. Prognostic value of interim 18F-FDG PET in patients with diffuse large B-Cell lymphoma: SUV-based assessment at 4 cycles of chemotherapy. J Nucl Med. 2009;50(4):527–33.
Vahdat S, Oermann EK, Collins SP, Yu X, Abedalthagafi M, DeBrito P, Suy S, Yousefi S, Gutierrez CJ, Chang T, Banovac F, Anderson ED, Esposito G, Collins BT. CyberKnife radiosurgery for inoperable stage IA non-small cell lung cancer: 18F-fluorodeoxyglucose positron emission tomography/computed tomography serial tumor response assessment. J Hematol Oncol. 2010;3:6–11.
Devic S, Tomic N, Faria S, Menard S, Lisbona R, Lehnert S. Defining radiotherapy target volumes using 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography: still a Pandora’s box? Int J Radiation Oncol Biol Phys. 2010;78(5):1555–62.
Hanna GG, Carson KJ, Lynch T, McAleese J, Cosgrove VP, Eakin R, Stewart DP, Zatari A, O’Sullivan JM, Hounsell AR. 18F-fluorodeoxyglucose positron emission tomography/computed tomography–based radiotherapy target volume definition in non–small-cell lung cancer: delineation by radiation oncologists vs. joint outlining with a PET radiologist? Int J Radiation Oncol Biol Phys. 2010;78(4):1040–51.
Han D, Yu J, Yu Y, et al. Comparison of 18F-fluorothymidine and 18F-fluorodeoxyglucose PET/CT in delineating gross tumor volume by optimal threshold in patients with squamous cell carcinoma of thoracic esophagus. Int J Radiation Oncol Biol Phys. 2010;76(4):1235–41.
Sattler B, Lee JA, Lonsdale M, Coche E. PET/CT (and CT) instrumentation, image reconstruction and data transfer for radiotherapy planning. Radiother Oncol. 2010;96(3):288–97.
Yap ML, Vinod SK, Shon IAH, Lin M, Fowler A, Gabriel G, Holloway LC. The registration of diagnostic versus planning fluorodeoxyglucose positron emission tomography/computed tomography in radiotherapy planning for non-small cell lung cancer. Clin Oncol. 2010;22(7):554–60.
Zaidi H, El Naqa I. PET-guided delineation of radiation therapy treatment volumes: a survey of image segmentation techniques. Eur J Nucl Med Mol Imaging. 2010;37:2165–87.
Choi WS, Lee SW, Park SH, Ryu JS, Oh SJ, Im KC, Choi EK, Kim JH, Jung SH, Kim SK, Ahn SD. Planning study for available dose of hypoxic tumor volume using fluorine-18-labeled fluoromisonidazole positron emission tomography for treatment of the head and neck cancer. Radiother Oncol. 2010;97(2):176–82.
Seppälä J, Seppänen M, Arponen E, Lindholm P, Minn H. Carbon-11 acetate PET/CT based dose escalated IMRT in prostate cancer. Radiother Oncol. 2009;93(2):234–40.
Chalkidou A, Landau DB, Odell EW, et al. Correlation between Ki-67 immunohistochemistry and 18F-Fluorothymidine uptake in patients with cancer: A systematic review and meta-analysis. Eur J Cancer. 2012 May [Epub ahead of print].
Chao KS, Bosch WR, Mutic S, et al. A novel approach to overcome hypoxic tumor resistance: Cu-ATSM-guided intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys. 2001;49(4):1171–82.
Lin Z, Mechalakos J, Nehmeh S et al. The influence of changes in tumor hypoxia on dose-painting treatment plans based on 18F-FMISO positron emission tomography. Int J Radiat Oncol Biol Phys. 2008;70(4):1219–28.
Kaanders JH, Bussink J, van der Kogel AJ. ARCON: a novel biology-based approach in radiotherapy. Lancet Oncol. 2002;3(12):728–37.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Lim, SM., Kim, E.E. (2013). Positron Emission Tomography in Radiation Treatment. In: Kim, E., Lee, MC., Inoue, T., Wong, WH. (eds) Clinical PET and PET/CT. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0802-5_31
Download citation
DOI: https://doi.org/10.1007/978-1-4419-0802-5_31
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-0801-8
Online ISBN: 978-1-4419-0802-5
eBook Packages: MedicineMedicine (R0)