PET-CT in radiation oncology: the impact on diagnosis, treatment planning, and assessment of treatment response.
OBJECTIVE
To review the role of hybrid positron emission tomography (PET)-computed tomography (CT) systems in the design and management of cancer patients in the modern radiation oncology practice. PET is co-registered with CT and incorporated into a systematic approach to the staging, management, and assessment of response and surveillance of a variety of oncologic diagnoses.


METHODS
A review of the literature of functional imaging such as PET-CT in staging, treatment plan design, assessment of response and detection of recurrence for tumors involving the head and neck, lung, esophagus, rectum amongst others.


RESULTS
PET and PET-CT offer significant advantages which include more accurate staging which often results in management changes in roughly one-third of patients across a number of disease site. More accurate target definition may augment highly conformal radiation treatment plans using intensity-modulated radiation therapy and stereotactic radiosurgery and radiotherapy.


CONCLUSIONS
The emerging data appears to suggest the functional imaging may be a more useful tool to evaluate the therapeutic effect of treatment, detect early failures and prognosticate long-term outcome.
University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. herond2@upmc.edu
Dwight E
DE
Heron
Regiane S
RS
Andrade
Sushil
S
Beriwal
Ryan P
RP
Smith
D002986:Clinical Trials as Topic; D006801:Humans; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D010347:Patient Care Planning; D049268:Positron-Emission Tomography / Q000379:methods*; D018787:Radiation Oncology; D019275:Radiopharmaceuticals; D011880:Radiotherapy Planning, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019275:Radiopharmaceuticals