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Dosimetric impact of positron emission tomography-based gross tumour volume (GTV) delineation over conventional CT-based GTV delineation for carcinoma oesophagus

Published online by Cambridge University Press:  11 May 2020

Karthikeyan Kalyanasundaram Open the ORCID record for Karthikeyan Kalyanasundaram [Opens in a new window] ,
Subramani Vellaiyan  and
Subramanian Shanmugam
Karthikeyan Kalyanasundaram
Affiliation:
Department of Radiation Oncology, Yashoda Hospitals, Secunderabad500003, India Research and Development Centre, Bharathiar University, Coimbatore641046, India
Subramani Vellaiyan*
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi110029, India Research and Development Centre, Bharathiar University, Coimbatore641046, India
Subramanian Shanmugam
Affiliation:
Department of Radiation Oncology, Yashoda Hospitals, Secunderabad500003, India Research and Development Centre, Bharathiar University, Coimbatore641046, India
*
Author for correspondence: Subramani Vellaiyan, Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi110029, India. Tel.: +91-9818590276, E-mail: karthikvsmani86@gmail.com
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Abstract

Aim:

The aim of the study was to find the dosimetric impact of positron emission tomography (PET)-based gross tumour volume (GTV) delineation over computed tomography (CT)-based GTV delineation for carcinoma oesophagus.

Methods:

Fifteen patients with carcinoma oesophagus were retrospectively selected. Two sets of GTVs in CT plain images were generated, one with the help of intravenous and oral contrast (GTV CT) and the other with only using PET uptake with the standardised uptake value (simple way of determining the activity in PET) (SUV) > 2.5 (GTV PET). Corresponding PTVs were generated. For all patients, rapid arc plans were generated. Changes in target volumes and critical structure doses were evaluated. The Wilcoxon signed-rank test was used for statistical analysis, and p value < 0.05 was assumed as statistically significant.

Results:

Mean reduction in GTV was 5.76 ± 19.35 cc. Mean reduction in PTV 45 Gy was 42.40 ± 76.39 cc. Mean reduction in heart mean dose was 1.53 ± 2.16 Gy. Mean reductions in left lung V20% and V10% were 2.43 ± 4.28 and 3.25 ± 5.09 Gy, respectively. Mean reductions in right lung V20% and V10% were 3.11 ± 4.91 and 2.80 ± 4.51 Gy, respectively. Mean reduction in total lung mean dose was 1.00 ± 1.19 Gy.

Finding:

PET-based GTV contouring reduces the treatment volume and critical structure doses significantly over CT-based GTV contouring for carcinoma oesophagus.

Keywords

GTVPETRapid ArcSUVTPS
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 3 , September 2021 , pp. 287 - 293
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Jordan, T J, Williams, P C. The design and performance characteristics of a multileaf collimator. Phys Med Biol 1994; 39 (2): 231–251.CrossRefGoogle ScholarPubMed
Diwanji, T P, Mohindra, P, Vyfhuis, M et al. Advances in radiotherapy techniques and delivery for non-small cell lung cancer: benefits of intensity-modulated radiation therapy, proton therapy, and stereotactic body radiation therapy. Trans Lung Cancer Research 2017, 6 (2): 131–147.CrossRefGoogle ScholarPubMed
Belohlavek, O, Carrio, I, Danna, M et al. The Role of PET/CT in Radiation Treatment Planning for Cancer Patient Treatment, Vienna: International Atomic Energy Agency, 2008.Google Scholar
Neuner, G, Patel, A, Suntharalingam, M. Chemoradiotherapy for esophageal cancer. Gastro Cancer Res 2009; 3 (2): 57–65.Google ScholarPubMed
Kachnic, LA, Winter, K, Wasserman, T et al. Longitudinal quality-of-life analysis of RTOG 94–05 (Int 0123): a phase III trial of definitive chemoradiotherapy for esophageal cancer. Gastro Cancer Res 2011; 4 (2): 45–52.Google ScholarPubMed
Chandna, P, Siddesh, M B, Jeevika, M U, Kochar, P K. CT imaging and staging of carcinoma oesophagus. Int J Res Med Sci 2017; 5 (5):2021–2029.CrossRefGoogle Scholar
Njeh, C F. Tumor delineation: the weakest link in the search for accuracy in radiotherapy. Journal of Medical Physics/Association of Medical Physicists of India 2008; 33 (4): 136–140.Google ScholarPubMed
Konski, A, Doss, M, Milestone, B, et al. The integration of 18-fluoro-deoxy-glucose positron emission tomography and endoscopic ultrasound in the treatment-planning process for esophageal carcinoma. Int J Rad Oncol Biol Phy 2005; 61: 1123–1128.CrossRefGoogle ScholarPubMed
Fukunaga, T, Okazumi, S, Koide, Y, Isono, K, Imazeki, K. Evaluation of esophageal cancers using fluorine-18-fluorodeoxyglucose PET. J Nuclear Med 1998; 39 (6): 1002–1007.Google ScholarPubMed
Zhong, X, Yu, J, Zhang, B et al. Using 18F-fluorodeoxyglucose positron emission tomography to estimate the length of gross tumor in patients with squamous cell carcinoma of the esophagus. Int J Rad Oncol Biol Phys 2009; 73 (1): 136–141.CrossRefGoogle ScholarPubMed
Wu, A J, Bosch, W R, Chang, D T, Hong, T S, Jabbour, S K, Kleinberg, L R. Expert consensus contouring guidelines for intensity modulated radiation therapy in esophageal and gastroesophageal junction cancer. Int J Rad Oncol Biol Phys 2015; 92 (4): 911–920.CrossRefGoogle ScholarPubMed
Moureau-Zabotto, L, Touboul, E, Lerouge, D et al. Impact of CT and 18F-deoxyglucose positron emission tomography image fusion for conformal radiotherapy in esophageal carcinoma. Int J Rad Oncol Biol Phys 2005; 63 (2): 340–345.CrossRefGoogle ScholarPubMed
Leong, T, Everitt, C, Yuen, K et al. A prospective study to evaluate the impact of FDG-PET on CT-based radiotherapy treatment planning for oesophageal cancer. Radiother Oncolo 2006; 78, 254–261.CrossRefGoogle ScholarPubMed
Seol, K H, Lee, J E. PET/CT planning during chemoradiotherapy for esophageal cancer. Rad Oncol J 2014; 32 (1): 31–42.CrossRefGoogle ScholarPubMed
Schiraldi, G, Popescu, C E, Chiericozzi, M et al. Role and sensitivity of Positron Emission Tomography with [18F] Fluorodeoxyglucose in diagnosis and follow-up of patients affected by chronic pulmonary aspergillosis (CPA). J Health Social Sci 2018; 3: 49–58.Google Scholar
Panjwani, N, Fero, K E, Murphy, J D. Cardiac toxicity with radiation therapy in esophageal cancer. Int J Rad Oncol Biol Phys 2016; 96: 151–152.CrossRefGoogle Scholar
Oh, P, Zhang, M, Brady, P et al. Impact of lung and heart dose on survival after radiotherapy for esophageal cancer. J Clin Oncol 2018; 36 (4): 3–3.CrossRefGoogle Scholar
Shi, A, Liao, Z, Allen, P K et al. Long-term survival and toxicity outcomes of intensity modulated radiation therapy for the treatment of esophageal cancer: a large single-institutional cohort study. Adv Rad Oncol 2017; 2 (3): 316–324.CrossRefGoogle ScholarPubMed
Frandsen, J, Boothe, D, Gaffney, D K, Wilson, B D, Lloyd, S. Increased risk of death due to heart disease after radiotherapy for esophageal cancer. J Gastrointestinal Oncol 2015; 6 (5): 516–523.Google ScholarPubMed
Yeung, H W, Macapinlac, H A, Mazumdar, M, Bains, M, Finn, R D, Larson, SM. FDG-PET in esophageal cancer: incremental value over computed tomography. Clin Positron Imaging 1999; 2 (5): 255–260.CrossRefGoogle ScholarPubMed
Anand, SS, Singh, H, Dash, AK. Clinical applications of PET and PET-CT. Med J Armed Forces India 2009; 65(4): 353–358.CrossRefGoogle ScholarPubMed