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Contribution of PET-CT to staging, gross tumour volume definition, planning and response assessment in IMRT for nasopharyngeal carcinoma

Published online by Cambridge University Press:  26 November 2010

Metin Guden ,
Cemile Ceylan ,
Kezban Berberoglu ,
Semih Dogan ,
Nadir Kucuk ,
Hande Bas ,
Ayhan Kilic  and
Kayıhan Engin
Metin Guden
Affiliation:
Department of Radiation Oncology, Anadolu Medical Center, Kocaeli, Turkey
Cemile Ceylan*
Affiliation:
Department of Radiation Oncology, Anadolu Medical Center, Kocaeli, Turkey
Kezban Berberoglu
Affiliation:
Department of Nuclear Medicine, Anadolu Medical Center, Kocaeli, Turkey
Semih Dogan
Affiliation:
Department of Nuclear Medicine, Anadolu Medical Center, Kocaeli, Turkey
Nadir Kucuk
Affiliation:
Department of Radiation Oncology, Anadolu Medical Center, Kocaeli, Turkey
Hande Bas
Affiliation:
Department of Radiation Oncology, Anadolu Medical Center, Kocaeli, Turkey
Ayhan Kilic
Affiliation:
Department of Radiation Oncology, Anadolu Medical Center, Kocaeli, Turkey
Kayıhan Engin
Affiliation:
Department of Radiation Oncology, Anadolu Medical Center, Kocaeli, Turkey
*
Correspondence to: Cemile Ceylan, Department of Radiation Oncology, Anadolu Medical Center, Anadolu caddesi No.1 Bayramoglu Cıkısı, Cayırova mevkii, Gebze 41400 Kocaeli, Turkey. E-mail: cemile.ceylan@anadolusaglik.org
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Abstract

The effectiveness of PET-CT (positron emission tomography–computed tomography) was investigated for staging target delineation compared with CT-MR (computed tomography–magnetic resonance) and early response of intensity-modulated radiotherapy (IMRT). Gross tumour volume–clinical target volume (GTV-CTV) differences between PET-CT and CT-MR for 14 nasopharyngeal carcinoma (NPC) patients were compared. Evaluation of doses of organs at risk (OARs) was done by IMRT plans. Responses of IMRT were evaluated with both sets. PET-CT changed MR-based TNM (Tumour Lymph Nodes Metastasis) in 11 of 14 patients. The median GTVNP (nasopharyx gross tumour volume) was 49.25 and 18.8 cm3 for CT-MR and PET-CT, respectively. In eight cases, GTVNP in the PET-CT was smaller than the CT-MR. The PET-CT presented a larger GTVNP than the CT-MR for six cases. Mean doses for the parotid glands were found to be higher than in CT-MR-based plan in one patient although he had smaller GTVNP at the PET-CT. The median follow-up was 16 months. Only one patient experienced recurrence in the CTVNP (nasopharyx clinical target volume). MR showed a decrease in the size-number of lymph nodes in four patients whereas PET-CT showed no uptake. All patients had positive responses to IMRT in their second control MR and PET-CT. PET-CT could improve tumour delineation. This enables an increase in dose inside the CTV. PET-CT provided significant information on the control scans for most of our patients whose MR imaging showed residual or recurrence.

Keywords

IMRTPET-CTnasopharyngeal carcinomaMR
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 10 , Issue 4 , December 2011 , pp. 272 - 282
Copyright
Copyright © Cambridge University Press 2010

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