title: Radiotherapy volume delineation using dynamic [18F]-FDG PET/CT imaging in patients with oropharyngeal cancer: a pilot study.
abstract: OBJECTIVE
  Delineation of gross tumour volume in 3D is a critical step in the radiotherapy (RT) treatment planning for oropharyngeal cancer (OPC). Static [18F]-FDG PET/CT imaging has been suggested as a method to improve the reproducibility of tumour delineation, but it suffers from low specificity. We undertook this pilot study in which dynamic features in time-activity curves (TACs) of [18F]-FDG PET/CT images were applied to help the discrimination of tumour from inflammation and adjacent normal tissue.
  
  
  METHODS
  Five patients with OPC underwent dynamic [18F]-FDG PET/CT imaging in treatment position. Voxel-by-voxel analysis was performed to evaluate seven dynamic features developed with the knowledge of differences in glucose metabolism in different tissue types and visual inspection of TACs. The Gaussian mixture model and K-means algorithms were used to evaluate the performance of the dynamic features in discriminating tumour voxels compared to the performance of standardized uptake values obtained from static imaging.
  
  
  RESULTS
  Some dynamic features showed a trend towards discrimination of different metabolic areas but lack of consistency means that clinical application is not recommended based on these results alone.
  
  
  CONCLUSIONS
  Impact of inflammatory tissue remains a problem for volume delineation in RT of OPC, but a simple dynamic imaging protocol proved practicable and enabled simple data analysis techniques that show promise for complementing the information in static uptake values.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland. anmisi@utu.fi.|Turku PET Centre, University of Turku, P.O. BOX 52, 20521, Turku, Finland. anmisi@utu.fi.
authors.forename: Antti
authors.initials: A
authors.lastname: Silvoniemi
authors.affiliation: Turku PET Centre, University of Turku, P.O. BOX 52, 20521, Turku, Finland.
authors.forename: Mueez U
authors.initials: MU
authors.lastname: Din
authors.affiliation: Department of Oncology and Radiotherapy, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland.|Department of Medical Physics, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland.
authors.forename: Sami
authors.initials: S
authors.lastname: Suilamo
authors.affiliation: Turku PET Centre, University of Turku, P.O. BOX 52, 20521, Turku, Finland.|Department of Oncology and Radiotherapy, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland.
authors.forename: Tony
authors.initials: T
authors.lastname: Shepherd
authors.affiliation: Turku PET Centre, University of Turku, P.O. BOX 52, 20521, Turku, Finland.|Department of Oncology and Radiotherapy, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Minn
mesh_terms: D000368:Aged; D000465:Algorithms; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D010865:Pilot Projects; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D011880:Radiotherapy Planning, Computer-Assisted; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Contouring; Dynamic PET/CT imaging; Oropharyngeal cancer; PET/CT; Radiotherapy; [18F]-FDG
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