title: Use of PET and PET/CT for radiation therapy planning: IAEA expert report 2006-2007.
abstract: Positron Emission Tomography (PET) is a significant advance in cancer imaging with great potential for optimizing radiation therapy (RT) treatment planning and thereby improving outcomes for patients. The use of PET and PET/CT in RT planning was reviewed by an international panel. The International Atomic Energy Agency (IAEA) organized two synchronized and overlapping consultants' meetings with experts from different regions of the world in Vienna in July 2006. Nine experts and three IAEA staff evaluated the available data on the use of PET in RT planning, and considered practical methods for integrating it into routine practice. For RT planning, (18)F fluorodeoxyglucose (FDG) was the most valuable pharmaceutical. Numerous studies supported the routine use of FDG-PET for RT target volume determination in non-small cell lung cancer (NSCLC). There was also evidence for utility of PET in head and neck cancers, lymphoma and in esophageal cancers, with promising preliminary data in many other cancers. The best available approach employs integrated PET/CT images, acquired on a dual scanner in the radiotherapy treatment position after administration of tracer according to a standardized protocol, with careful optimization of images within the RT planning system and carefully considered rules for contouring tumor volumes. PET scans that are not recent or were acquired without proper patient positioning should be repeated for RT planning. PET will play an increasing valuable role in RT planning for a wide range of cancers. When requesting PET scans, physicians should be aware of their potential role in RT planning.
authors.affiliation: Department of Radiation Oncology, Peter MacCallum Cancer Centre, Australia. michael.macmanus@petermac.org
authors.forename: Michael
authors.initials: M
authors.lastname: MacManus
authors.forename: Ursula
authors.initials: U
authors.lastname: Nestle
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Rosenzweig
authors.forename: Ignasi
authors.initials: I
authors.lastname: Carrio
authors.forename: Cristina
authors.initials: C
authors.lastname: Messa
authors.forename: Otakar
authors.initials: O
authors.lastname: Belohlavek
authors.forename: Massimo
authors.initials: M
authors.lastname: Danna
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Deniaud-Alexandre
authors.forename: Stefano
authors.initials: S
authors.lastname: Schipani
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Watanabe
authors.forename: Maurizio
authors.initials: M
authors.lastname: Dondi
authors.forename: Branislav
authors.initials: B
authors.lastname: Jeremic
mesh_terms: D019788:Fluorodeoxyglucose F18; D006801:Humans; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18