Evaluation of the role of (18)FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer

K. L. Newbold; M. Partridge; G. Cook; B. Sharma; P. Rhys-Evans; K. J. Harrington; C. M. Nutting

doi:10.1080/02841860802256483

Evaluation of the role of (18)FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer

K. L. Newbold, M. Partridge, G. Cook, B. Sharma, P. Rhys-Evans, K. J. Harrington, C. M. Nutting

Imaging and Biomedical Engineering

Research output: Contribution to journal › Article › peer-review

22 Citations (Scopus)

Abstract

Background and purpose. As techniques for radiotherapy delivery have developed, increasingly accurate localisation of disease is demanded. Functional imaging, particularly PET and its fusion with anatomical modalities, such as PET/CT, promises to improve detection and characterisation of disease. This study evaluated the impact of (18)FDG-PET/CT on radiotherapy target volume definition in head and neck cancer (HNC). Materials and methods. The PET/CT scans of patients with HNC were used in a radiotherapy planning (RTP) study. The gross tumour volume (GTV), clinical target volume (CTV) and planning target volume (PTV) were defined conventionally and compared to those defined using the PET/CT. Data were reported as the median value with 95% confidence intervals. Results. Eighteen patients were consented, 9 had known primary tumour site, 9 presented as unknown primary. In nine cases where the primary site was known, the combined primary and nodal GTV (GTVp+n) increased by a median of 6.1cm(3) (2.6, 12.2) or 78% (18, 313), p=0.008 with CTV increasing by a median of 10.1cm(3) (1.3, 30.6) or 4% (0, 13) p=0.012. In 9 cases of unknown primary the GTVp+n increased by a median 6.3cm(3) (0.2, 15.7) or 61% (4, 210), p=0.012, with CTV increasing by a median 155.4cm3 (2.7, 281.7) or 95% (1, 137), p=0.008. Conclusion. (18)FDG-PET revealed disease lying outside the conventional target volume, either extending a known area or highlighting a previously unknown area of disease, including the primary tumour in 5 cases. We recommend PET/CT in the RTP of all cases of unknown primary. In patients with a known primary, although the change in volume was statistically significant the clinical impact is less clear. (18)FDG-PET can also show areas within the conventional target volume that are hypermetabolic which may be possible biological target volumes for dose escalation studies in the future.

Original language	English
Pages (from-to)	1229-1236
Number of pages	8
Journal	Acta Oncologica
Volume	47
Issue number	7
DOIs	https://doi.org/10.1080/02841860802256483
Publication status	Published - 2008

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@article{be2038019c234072809666ca9cf709e8,

title = "Evaluation of the role of (18)FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer",

abstract = "Background and purpose. As techniques for radiotherapy delivery have developed, increasingly accurate localisation of disease is demanded. Functional imaging, particularly PET and its fusion with anatomical modalities, such as PET/CT, promises to improve detection and characterisation of disease. This study evaluated the impact of (18)FDG-PET/CT on radiotherapy target volume definition in head and neck cancer (HNC). Materials and methods. The PET/CT scans of patients with HNC were used in a radiotherapy planning (RTP) study. The gross tumour volume (GTV), clinical target volume (CTV) and planning target volume (PTV) were defined conventionally and compared to those defined using the PET/CT. Data were reported as the median value with 95% confidence intervals. Results. Eighteen patients were consented, 9 had known primary tumour site, 9 presented as unknown primary. In nine cases where the primary site was known, the combined primary and nodal GTV (GTVp+n) increased by a median of 6.1cm(3) (2.6, 12.2) or 78% (18, 313), p=0.008 with CTV increasing by a median of 10.1cm(3) (1.3, 30.6) or 4% (0, 13) p=0.012. In 9 cases of unknown primary the GTVp+n increased by a median 6.3cm(3) (0.2, 15.7) or 61% (4, 210), p=0.012, with CTV increasing by a median 155.4cm3 (2.7, 281.7) or 95% (1, 137), p=0.008. Conclusion. (18)FDG-PET revealed disease lying outside the conventional target volume, either extending a known area or highlighting a previously unknown area of disease, including the primary tumour in 5 cases. We recommend PET/CT in the RTP of all cases of unknown primary. In patients with a known primary, although the change in volume was statistically significant the clinical impact is less clear. (18)FDG-PET can also show areas within the conventional target volume that are hypermetabolic which may be possible biological target volumes for dose escalation studies in the future.",

author = "Newbold, {K. L.} and M. Partridge and G. Cook and B. Sharma and P. Rhys-Evans and Harrington, {K. J.} and Nutting, {C. M.}",

note = "M1 - 7 Newbold, Katie L. Partridge, Mike Cook, Gary Sharma, Bhupinder Rhys-Evans, Peter Harrington, Kevin J. Nutting, Christopher. M. 6th Acta Oncologica Symposium 2008 Jun 05-07, 2008 Aarhus, DENMARK",

year = "2008",

doi = "10.1080/02841860802256483",

language = "English",

volume = "47",

pages = "1229--1236",

journal = "Acta Oncologica",

issn = "0284-186X",

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T1 - Evaluation of the role of (18)FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer

AU - Newbold, K. L.

AU - Partridge, M.

AU - Cook, G.

AU - Sharma, B.

AU - Rhys-Evans, P.

AU - Harrington, K. J.

AU - Nutting, C. M.

N1 - M1 - 7 Newbold, Katie L. Partridge, Mike Cook, Gary Sharma, Bhupinder Rhys-Evans, Peter Harrington, Kevin J. Nutting, Christopher. M. 6th Acta Oncologica Symposium 2008 Jun 05-07, 2008 Aarhus, DENMARK

PY - 2008

Y1 - 2008

N2 - Background and purpose. As techniques for radiotherapy delivery have developed, increasingly accurate localisation of disease is demanded. Functional imaging, particularly PET and its fusion with anatomical modalities, such as PET/CT, promises to improve detection and characterisation of disease. This study evaluated the impact of (18)FDG-PET/CT on radiotherapy target volume definition in head and neck cancer (HNC). Materials and methods. The PET/CT scans of patients with HNC were used in a radiotherapy planning (RTP) study. The gross tumour volume (GTV), clinical target volume (CTV) and planning target volume (PTV) were defined conventionally and compared to those defined using the PET/CT. Data were reported as the median value with 95% confidence intervals. Results. Eighteen patients were consented, 9 had known primary tumour site, 9 presented as unknown primary. In nine cases where the primary site was known, the combined primary and nodal GTV (GTVp+n) increased by a median of 6.1cm(3) (2.6, 12.2) or 78% (18, 313), p=0.008 with CTV increasing by a median of 10.1cm(3) (1.3, 30.6) or 4% (0, 13) p=0.012. In 9 cases of unknown primary the GTVp+n increased by a median 6.3cm(3) (0.2, 15.7) or 61% (4, 210), p=0.012, with CTV increasing by a median 155.4cm3 (2.7, 281.7) or 95% (1, 137), p=0.008. Conclusion. (18)FDG-PET revealed disease lying outside the conventional target volume, either extending a known area or highlighting a previously unknown area of disease, including the primary tumour in 5 cases. We recommend PET/CT in the RTP of all cases of unknown primary. In patients with a known primary, although the change in volume was statistically significant the clinical impact is less clear. (18)FDG-PET can also show areas within the conventional target volume that are hypermetabolic which may be possible biological target volumes for dose escalation studies in the future.

AB - Background and purpose. As techniques for radiotherapy delivery have developed, increasingly accurate localisation of disease is demanded. Functional imaging, particularly PET and its fusion with anatomical modalities, such as PET/CT, promises to improve detection and characterisation of disease. This study evaluated the impact of (18)FDG-PET/CT on radiotherapy target volume definition in head and neck cancer (HNC). Materials and methods. The PET/CT scans of patients with HNC were used in a radiotherapy planning (RTP) study. The gross tumour volume (GTV), clinical target volume (CTV) and planning target volume (PTV) were defined conventionally and compared to those defined using the PET/CT. Data were reported as the median value with 95% confidence intervals. Results. Eighteen patients were consented, 9 had known primary tumour site, 9 presented as unknown primary. In nine cases where the primary site was known, the combined primary and nodal GTV (GTVp+n) increased by a median of 6.1cm(3) (2.6, 12.2) or 78% (18, 313), p=0.008 with CTV increasing by a median of 10.1cm(3) (1.3, 30.6) or 4% (0, 13) p=0.012. In 9 cases of unknown primary the GTVp+n increased by a median 6.3cm(3) (0.2, 15.7) or 61% (4, 210), p=0.012, with CTV increasing by a median 155.4cm3 (2.7, 281.7) or 95% (1, 137), p=0.008. Conclusion. (18)FDG-PET revealed disease lying outside the conventional target volume, either extending a known area or highlighting a previously unknown area of disease, including the primary tumour in 5 cases. We recommend PET/CT in the RTP of all cases of unknown primary. In patients with a known primary, although the change in volume was statistically significant the clinical impact is less clear. (18)FDG-PET can also show areas within the conventional target volume that are hypermetabolic which may be possible biological target volumes for dose escalation studies in the future.

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DO - 10.1080/02841860802256483

M3 - Article

SN - 0284-186X

VL - 47

SP - 1229

EP - 1236

JO - Acta Oncologica

JF - Acta Oncologica

IS - 7

ER -

Evaluation of the role of (18)FDG-PET/CT in radiotherapy target definition in patients with head and neck cancer

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