title: 18FDG-PET/CT Definition of Clinical Target Volume for Robotic Stereotactic Body Radiosurgery Treatment of Metastatic Gynecologic Malignancies.
abstract: The objective of the current article was to evaluate 2-[18F]fluoro-2-deoxy-D-glucose18F-FDG) as measured by positron emission tomography for delineation of abdominopelvic gross tumor volumes (GTV) for stereotactic body radiosurgery treatment (SBRT) of metastatic gynecologic cancers. A retrospective review of SBRT was conducted in 27 women with stage IV gynecologic cancers recurring in para-aortic lymph nodes. Robotic SBRT involved 2400 cGy in 3 consecutive 800 cGy daily fractions prescribed to a 3.0 mm expanded planning tumor volume (PTV) defined by both CT-based and18F-FDG-based GTVs. In this study,18F-FDG-based GTVs led to significantly larger PTVs in all 27 women, than if they had been based on CT GTVs alone (P< 0.001). Enlarged PTVs may have resulted from the breathing-induced target motion during the time of18F-FDG image acquisition smearing18F-FDG signal over a greater anatomic dimension. Ultimately, SBRT-target local control, based on the RECIST 1.1 criteria, was 96% (26 of 27), and associated with minor reversible toxicity. The use of18F-FDG to define SBRT target volumes warrants further interrogation in SBRT clinical trials.
authors.affiliation: Departments of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Kunos
authors.affiliation: Obstetrics and Gynecology Division of Gynecologic Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Debernardo
authors.affiliation: Departments of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fabien
authors.affiliation: Departments of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Dobbins
authors.affiliation: Departments of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
authors.forename: Yuxia
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Departments of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
authors.forename: James
authors.initials: J
authors.lastname: Brindle
authors.affiliation: Radiology Division of Nuclear Medicine, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Faulhaber