title: 18F-deoxyglucose positron emission tomography (FDG-PET) for the planning of radiotherapy in lung cancer: high impact in patients with atelectasis.
abstract: OBJECTIVE
  18F-deoxyglucose positron emission tomography (FDG-PET) is increasingly applied in the staging of lung cancer (LC). This study analyzes the potential contribution of PET in radiotherapy planning for LC with special respect to tumor-associated atelectasis.
  
  
  METHODS
  Thirty-four patients with histologically confirmed LC, who had been examined by PET during pretreatment staging, were included. All were irradiated after CT-based therapy planning with anterior/posterior (AP) portals encompassing the primary tumor and the mediastinum (CT portals, CP). The result of the PET examination was unknown in treatment planning. In retrospect, a PET portal (PP) was delineated and compared with the CP.
  
  
  RESULTS
  In 12/34 cases, the shape and/or size of the portals were changed, primarily (n = 10) the size of the fields was reduced. The median area of CP was 182 cm2 versus 167 cm2 of PP. Seventeen of 34 patients had dys- or atelectasis caused by a central primary tumor. In these cases, differences between CP and PP were significantly more frequent than in the other patients (8/17 vs. 3/17, p = 0.03).
  
  
  CONCLUSIONS
  In this retrospective analysis, the information provided by FDG-PET would have contributed to a substantial reduction of the size of radiotherapy portals. This applies particularly for patients with tumor-associated dys- or atelectasis.
authors.affiliation: Department of Radiotherapy, Saarland University Medical Center Homburg/Saar, Germany. raunes@med-rz.uni-sb.de
authors.forename: U
authors.initials: U
authors.lastname: Nestle
authors.forename: K
authors.initials: K
authors.lastname: Walter
authors.forename: S
authors.initials: S
authors.lastname: Schmidt
authors.forename: N
authors.initials: N
authors.lastname: Licht
authors.forename: C
authors.initials: C
authors.lastname: Nieder
authors.forename: B
authors.initials: B
authors.lastname: Motaref
authors.forename: D
authors.initials: D
authors.lastname: Hellwig
authors.forename: M
authors.initials: M
authors.lastname: Niewald
authors.forename: D
authors.initials: D
authors.lastname: Ukena
authors.forename: C M
authors.initials: CM
authors.lastname: Kirsch
authors.forename: G W
authors.initials: GW
authors.lastname: Sybrecht
authors.forename: K
authors.initials: K
authors.lastname: Schnabel
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18