title: Usefulness of four dimensional (4D) PET/CT imaging in the evaluation of thoracic lesions and in radiotherapy planning: Review of the literature.
abstract: In the past decade, Positron Emission Tomography (PET) has become a routinely used methodology for the assessment of solid tumors, which can detect functional abnormalities even before they become morphologically evident on conventional imaging. PET imaging has been reported to be useful in characterizing solitary pulmonary nodules, guiding biopsy, improving lung cancer staging, guiding therapy, monitoring treatment response and predicting outcome. This review focuses on the most relevant and recent literature findings, highlighting the current role of PET/CT and the evaluation of 4D-PET/CT modality for radiation therapy planning applications. Current evidence suggests that gross tumor volume delineation based on 4D-PET/CT information may be the best approach currently available for its delineation in thoracic cancers (lung and non-lung lesions). In our opinion, its use in this clinical setting is strongly encouraged, as it may improve patient treatment outcome in the setting of radiation therapy for cancers of the thoracic region, not only involving lung, but also lymph nodes and esophageal tissue. Literature results warrants further investigation in future prospective studies, especially in the setting of dose escalation.
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Italy. Electronic address: alessandrosindoni@alice.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sindoni
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Minutoli
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pontoriero
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iatì
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Baldari
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pergolizzi
mesh_terms: D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy; D019788:Fluorodeoxyglucose F18; D056973:Four-Dimensional Computed Tomography / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Four dimensional PET/CT; Lung cancer; Radiation therapy