[Individualised radiotherapy on the basis of functional imaging with FMISO PET].
A dose painting strategy in order to overcome hypoxia-induced radiation resistance is presented. 15 HNC patients were examined with 18F-FDG and dynamic 18F-FMISO PET before the start of a 70Gy radiotherapy. After approx. 20 Gy, a second dynamic 18F-FMISO scan was performed The voxelbased 18F-FMISO PET data were analysed with a kinetic model, which allows for the determination of local tumour parameters for hypoxia and tissue perfusion. A statistical analysis showed, that only a combination of these two parameters predicted treatment outcome. A translation of the imaging data into a reliable dose prescription can only be reached via a TCP model that includes these functional parameters. The developed model was calibrated using the outcome data of the 15 HNC patients. This model allows to determine a map of locally varying dose escalation factors to be used for radiotherapy planning. A planning study showed that hypoxia dose painting is feasible without a higher burden for the organs at risk.
Sektion für Biomedizinische Physik, Universitätsklinik für Radioonkologie Tübingen. daniela.thorwarth@med.uni-tuebingen.de
Daniela
D
Thorwarth
Markus
M
Alber
D003952:Diagnostic Imaging; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007700:Kinetics; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy; D049268:Positron-Emission Tomography / Q000379:methods*; D011838:Radiation-Sensitizing Agents; D011878:Radiotherapy / Q000379:methods*
D005462:Fluorine Radioisotopes; D011838:Radiation-Sensitizing Agents; D019788:Fluorodeoxyglucose F18