First experiences of radiation treatment planning with PET/CT.
BACKGROUND
Positron emission tomography/computed tomography (PET/CT) is composed of modern CT and PET technology in one machine enabling examinations of patients in one session in the same position. Its value for modern radiation treatment planning is under investigation.


METHODS
In 53 patients with head-and-neck (n = 11), non-small cell lung (n = 16), prostate (n = 14) and other cancers (n = 12), a PET/CT investigation was performed. During the diagnostic examination process an integrated scan under radiation treatment-planning conditions was included. Interpretation and delineation of macroscopic tumor were done in an interdisciplinary approach. Treatment changes occurred after critical interpretation of the PET/CT findings by the responsible radiotherapist. Analysis is descriptive with regard to changes in treatment intention, mode, radiation volumes and doses.


RESULTS
Examinations were well tolerated. CT datasets in treatment position could be used for planning. Delineation of macroscopic tumor led to changes of the planning target volume after PET/CT 15 times, total dose was modified twelve times. PET/CT examinations led to changes of the general treatment mode in 19 cases. Using the separate CT and PET datasets, fusion in the planning software was easily performed in all patients due to the use of the same positioning and immobilization devices in PET/CT.


CONCLUSIONS
Despite the low number of patients and an expected bias of selection, the first results are encouraging to perform more extended and detailed trials of this technology in radiotherapy planning. Whether PET/CT is superior to PET alone is part of ongoing investigations.
Paulsen
Frank
F
Clinic for Radiation Oncology, University of Tuebingen, Germany. frank.paulsen@uni-tuebingen.de
Scheiderbauer
Jutta
J
Eschmann
Susanne Martina
SM
Brechtel
Klaus
K
Klein
Magnus
M
Pfannenberg
Christina
C
Mondry
Andre
A
Hehr
Thomas
T
Belka
Claus
C
Bamberg
Michael
M
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D018401:Sample Size; D015983:Selection Bias; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome