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PET/CT-guided treatment planning for paediatric cancer patients : A simulation study of proton and conventional photon therapy

Kornerup, Josefine Ståhl ; Brodin, N. P. ; Björk-Eriksson, T. ; Birk Christensen, C. ; Kiil-Berthelsen, A. ; Aznar, M. C. ; Hollensen, C. ; Markova, E. and Munck Af Rosenschöld, P. LU orcid (2015) In British Journal of Radiology 88(1047).
Abstract

Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT-and PET/CT-guided target volumes were seen... (More)

Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT-and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT.

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author
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publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Radiology
volume
88
issue
1047
article number
20140586
publisher
British Institute of Radiology
external identifiers
  • pmid:25494657
  • scopus:84923480339
ISSN
0007-1285
DOI
10.1259/bjr.20140586
language
English
LU publication?
no
additional info
Publisher Copyright: © 2015 The Authors. Published by the British Institute of Radiology.
id
b1269cb5-1470-4315-8927-d98e58c76c45
date added to LUP
2023-07-19 17:01:50
date last changed
2024-01-05 03:31:27
@article{b1269cb5-1470-4315-8927-d98e58c76c45,
  abstract     = {{<p>Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (<sub>18</sub>F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to <sub>18</sub>F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT-and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: <sub>18</sub>F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT.</p>}},
  author       = {{Kornerup, Josefine Ståhl and Brodin, N. P. and Björk-Eriksson, T. and Birk Christensen, C. and Kiil-Berthelsen, A. and Aznar, M. C. and Hollensen, C. and Markova, E. and Munck Af Rosenschöld, P.}},
  issn         = {{0007-1285}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{1047}},
  publisher    = {{British Institute of Radiology}},
  series       = {{British Journal of Radiology}},
  title        = {{PET/CT-guided treatment planning for paediatric cancer patients : A simulation study of proton and conventional photon therapy}},
  url          = {{http://dx.doi.org/10.1259/bjr.20140586}},
  doi          = {{10.1259/bjr.20140586}},
  volume       = {{88}},
  year         = {{2015}},
}