Document Detail


FDG-PET/CT imaging for staging and target volume delineation in preoperative conformal radiotherapy of rectal cancer.
MedLine Citation:
PMID:  17931795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate the potential impact of using (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) on staging and target volume delineation for patients affected by rectal cancer and candidates for preoperative conformal radiotherapy. METHODS AND MATERIALS: Twenty-five patients diagnosed with rectal cancer T3-4 N0-1 M0-1 and candidates for preoperative radiotherapy underwent PET/CT simulation after injection of 5.18 MBq/kg of FDG. Clinical stage was reassessed on the basis of FDG-PET/CT findings. The gross tumor volume (GTV) and the clinical target volume (CTV) were delineated first on CT and then on PET/CT images. The PET/CT-GTV and PET/CT-CTV were analyzed and compared with CT-GTV and CT-CTV, respectively. RESULTS: In 4 of 25 cases (24%), PET/CT affected tumor staging or the treatment purpose. In 3 of 25 cases (12%) staged N0 M0, PET/CT showed FDG uptake in regional lymph nodes and in a case also in the liver. In a patient with a single liver metastasis PET/CT detected multiple lesions, changing the treatment intent from curative to palliative. The PET/CT-GTV and PET/CT-CTV were significantly greater than the CT-GTV (p = 0.00013) and CT-CTV (p = 0.00002), respectively. The mean difference between PET/CT-GTV and CT-GTV was 25.4% and between PET/CT-CTV and CT-CTV was 4.1%. CONCLUSIONS: Imaging with PET/CT for preoperative radiotherapy of rectal cancer may lead to a change in staging and target volume delineation. Stage variation was observed in 12% of cases and a change of treatment intent in 4%. The GTV and CTV changed significantly, with a mean increase in size of 25% and 4%, respectively.
Authors:
Maria Chiara Bassi; Lucia Turri; Gianmauro Sacchetti; Gianfranco Loi; Barbara Cannillo; Pierdaniele La Mattina; Marco Brambilla; Eugenio Inglese; Marco Krengli
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2007-10-10
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  70     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-31     Completed Date:  2008-06-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1423-6     Citation Subset:  IM    
Affiliation:
Department of Radiotherapy, University of Piemonte Orientale, Novara, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Burden
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Liver Neoplasms / secondary
Lymphatic Metastasis / radiography,  radionuclide imaging
Male
Middle Aged
Neoplasm Staging / methods
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use*
Radiotherapy, Conformal
Rectal Neoplasms* / pathology,  radiography,  radionuclide imaging
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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