F-18 FDG PET-CT Influences Target Delineation When Combined With Standard CT-Based Radiotherapy Planning in the Palliative Setting in Malignant Pleural Mesothelioma; an Exploratory Study

AuthorNicholas Mac Leoden
AuthorJon Stoboen
AuthorNoelle O’Rourkeen
AuthorJonathan Hicksen
AuthorKaren Mooreen
AuthorMarimuthu Sankaralingamen
AuthorKurian Oommenen
AuthorCaroline Kellyen
AuthorLynn McMahonen
AuthorFat Wi Poonen
AuthorSai Hanen
AuthorCaroline Findlayen
AuthorAnthony Chalmersen
AuthorMarie Fallonen
AuthorBarry J. Lairden
Issued Date2015-06-28en
AbstractBackground:: Positron emission tomography computerized tomography (PET-CT) is useful in radiotherapy planning for lung cancer. However, its role in malignant pleural mesothelioma (MPM) is unknown. Objectives:: This exploratory study investigated the possible role for PET-CT in radiotherapy planning for MPM. Patients and Methods:: Patients receiving radiotherapy for the treatment of pain in MPM, had fluorodeoxyglucose (FDG) PET-CT scanning in addition to their standard CT scan. PET-CT images were then fused with CT planning images, termed Planning-PET-CT. Target volume delineation was undertaken first using CT and subsequently incorporated Planning-PET-CT. Planning treatment volume (PTV), conformity index (CI), mean distance to conformity (MDC), center of gravity distance (CGD) and standard uptake values (SUV) were examined. Results:: Sixteen patients were recruited into the study. PET-CT upstaged nine patients. No association between SUV max and either survival or pain response was seen. Volumes contoured using Planning-PET-CT differed markedly from those outlined using CT alone as shown by the following parameters: CI = 0.3 (0.24 - 0.38). MDC = 21.47 (16.73 - 33.70) and CGD = 16.40 (11.80 - 33.87). The median percentage of over contouring was 44.00% (34.33 - 72.50) with 46.67% under contoured (34.00 - 55.00). Conclusions:: PET-CT alters the position of the PTV in MPM and upstaged a proportion of patients. Further work to elucidate the role of Planning-PET-CT in target volume definition is justified.en
DOIhttps://doi.org/10.17795/rro-3999en
KeywordPositron Emission Tomography Computerized Tomography (PET-CT)en
KeywordRadiotherapyen
KeywordMesotheliomaen
PublisherBrieflandsen
TitleF-18 FDG PET-CT Influences Target Delineation When Combined With Standard CT-Based Radiotherapy Planning in the Palliative Setting in Malignant Pleural Mesothelioma; an Exploratory Studyen
TypeResearch Articleen

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