18F-FDG PET definition of gross tumor volume for radiotherapy of lung cancer: is the tumor uptake value-based approach appropriate for lymph node delineation?

International Journal of Radiation Oncology, Biology, Physics
Núria RodríguezManuel Algara

Abstract

Positron emission tomography (PET) with the glucose analogue [18F] fluoro-2-deoxy-D-glucose ((18)F-FDG-PET) has been used in radiation treatment planning for non-small-cell carcinoma. To date, lymph nodes have been contoured according to the uptake of the tumor. This prospective study was performed to evaluate if nodal volume delineates according to FDG uptake within the primary tumor (PET-GTVnt) is suitable for nodal target volume delineation or if individualized nodal FDG uptake measure (PET-GTVnn) is necessary to better nodal target definition. Forty cases, who underwent a diagnostic (18)F-FDG PET/computed tomography (CT) scan, were included. Two PET-based GTVs for each lymph node were contoured and compared. First, we used an isocontour of 40% of the maximum tumor uptake (PET-GTVnt). Second, an isocontour of 40% of the maximum uptake of each node (PET-GTVnn) was employed. To avoid interobserver variability, this was carried out by the same radiation oncologist. Afterwards, the difference between both lymph node volumes was plotted against the ratio of the maximum uptakes (I(n)/I(t)) in a linear regression analysis. Compared with CT-based lymph node volume (CT-GTVn), the intraclass correlation coefficient of PET-GTVnn was hi...Continue Reading

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Citations

Sep 26, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Guan-hao ChenGuo-liang Jiang
Jun 6, 2012·International Journal of Molecular Imaging·Katsuyuki ShiraiTakashi Nakano
Aug 25, 2016·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·N Rodríguez de DiosM Algara

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