title: The use of FDG-PET to target tumors by radiotherapy.
abstract: Fluorodeoxyglucose positron emission tomography (FDG-PET) plays an increasingly important role in radiotherapy, beyond staging and selection of patients. Especially for non-small cell lung cancer, FDG-PET has, in the majority of the patients, led to the safe decrease of radiotherapy volumes, enabling radiation dose escalation and, experimentally, redistribution of radiation doses within the tumor. In limited-disease small cell lung cancer, the role of FDG-PET is emerging. For primary brain tumors, PET based on amino acid tracers is currently the best choice, including high-grade glioma. This is especially true for low-grade gliomas, where most data are available for the use of (11)C-MET (methionine) in radiation treatment planning. For esophageal cancer, the main advantage of FDG-PET is the detection of otherwise unrecognized lymph node metastases. In Hodgkin's disease, FDG-PET is essential for involved-node irradiation and leads to decreased irradiation volumes while also decreasing geographic miss. FDG-PET's major role in the treatment of cervical cancer with radiation lies in the detection of para-aortic nodes that can be encompassed in radiation fields. Besides for staging purposes, FDG-PET is not recommended for routine radiotherapy delineation purposes. It should be emphasized that using PET is only safe when adhering to strictly standardized protocols.
authors.affiliation: MAASTRO Clinic, Radiation Oncology, Maastricht, The Netherlands. guido.lammering@maastro.nl
authors.forename: Guido
authors.initials: G
authors.lastname: Lammering
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ruysscher
authors.forename: Angela
authors.initials: A
authors.lastname: van Baardwijk
authors.forename: Brigitta G
authors.initials: BG
authors.lastname: Baumert
authors.forename: Jacques
authors.initials: J
authors.lastname: Borger
authors.forename: Ludy
authors.initials: L
authors.lastname: Lutgens
authors.forename: Piet
authors.initials: P
authors.lastname: van den Ende
authors.forename: Michel
authors.initials: M
authors.lastname: Ollers
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000532:radiotherapy; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
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