FDG-PET/CT imaging for staging and radiotherapy treatment planning of head and neck carcinoma.
BACKGROUND
Positron emission tomography (PET) has a potential improvement for staging and radiation treatment planning of various tumor sites. We analyzed the use of 18F-fluorodeoxyglucose (FDG)-PET/computed tomography (CT) images for staging and target volume delineation of patients with head and neck carcinoma candidates for radiotherapy.


METHODS
Twenty-two patients candidates for primary radiotherapy, who did not receive any curative surgery, underwent both CT and PET/CT simulation. Gross Tumor Volume (GTV) was contoured on CT (CT-GTV), PET (PET-GTV), and PET/CT images (PET/CT-GTV). The resulting volumes were analyzed and compared.


RESULTS
Based on PET/CT, changes in TNM categories and clinical stage occurred in 5/22 cases (22%). The difference between CT-GTV and PET-GTV was not statistically significant (p = 0.2) whereas the difference between the composite volume (PET/CT-GTV) and CT-GTV was statistically significant (p < 0.0001).


CONCLUSIONS
PET/CT fusion images could have a potential impact on both tumor staging and treatment planning.
Deantonio
Letizia
L
Radiotherapy, University of Piemonte Orientale Amedeo Avogadro, Novara, Italy. letizia.deantonio@libero.it
Beldì
Debora
D
Gambaro
Giuseppina
G
Loi
Gianfranco
G
Brambilla
Marco
M
Inglese
Eugenio
E
Krengli
Marco
M
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis* / Q000532:radiotherapy*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
Radiology. 2004 Oct;233(1):93-100
15317953
Int J Radiat Oncol Biol Phys. 2008 Apr 1;70(5):1423-6
17931795
Int J Radiat Oncol Biol Phys. 2007 Jul 1;68(3):763-70
17379435
Eur J Radiol. 2007 May;62(2):199-204
17223003
Med Phys. 2006 Nov;33(11):4280-8
17153406
Semin Nucl Med. 2006 Jul;36(3):248-56
16762614
Cancer Treat Rev. 2006 Jun;32(4):245-60
16563636
Int J Radiat Oncol Biol Phys. 2006 Jul 1;65(3):726-32
16626888
Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):143-51
16618577
Head Neck. 2005 Jun;27(6):494-502
15772951
Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1385-92
15817341
Int J Radiat Oncol Biol Phys. 2005 Jan 1;61(1):129-36
15629603
Int J Radiat Oncol Biol Phys. 2004 Dec 1;60(5):1419-24
15590173
Int J Radiat Oncol Biol Phys. 2004 Nov 15;60(4):1272-82
15519800
Int J Radiat Oncol Biol Phys. 1998 Jan 1;40(1):197-205
9422577
Cancer. 1997 Dec 15;80(12 Suppl):2505-9
9406703
J Nucl Med. 2003 Jul;44(7):1156-67
12843232
Semin Nucl Med. 2003 Jul;33(3):238-43
12931325
J Nucl Med. 2003 Jan;44(1):24-9
12515872
J Clin Oncol. 2002 Oct 15;20(20):4199-208
12377963
Int J Radiat Oncol Biol Phys. 2002 Jul 15;53(4):1051-7
12095574
Radiother Oncol. 2002 Jan;62(1):51-60
11830312
N Engl J Med. 2001 Dec 27;345(26):1890-900
11756581
Int J Radiat Oncol Biol Phys. 2001 Sep 1;51(1):4-9
11516844
Br J Radiol. 2002 Nov;75 Spec No:S1-5
12523320