PMID- 17707283
OWN - NLM
STAT- MEDLINE
DCOM- 20071015
LR  - 20161124
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 69
IP  - 1
DP  - 2007 Sep 1
TI  - [18FDG] PET-CT-based intensity-modulated radiotherapy treatment planning of head 
      and neck cancer.
PG  - 286-93
AB  - PURPOSE: To define the best threshold for tumor volume delineation of the (18) 
      fluoro-2-deoxy-glucose positron emission tomography ((18)FDG-PET) signal for 
      radiotherapy treatment planning of intensity-modulated radiotherapy (IMRT) in 
      head and neck cancer. METHODS AND MATERIALS: In 25 patients with head-and-neck 
      cancer, CT-based gross tumor volume (GTV(CT)) was delineated. After PET-CT image 
      fusion, window level (L) was adapted to best fit the GTV(CT), and GTV(PET) was 
      delineated. Tumor maximum (S) and background uptake (B) were measured, and the 
      threshold of the background-subtracted tumor maximum uptake (THR) was used for 
      PET signal segmentation. Gross tumor volumes were expanded to planning target 
      volumes (PTVs) and analyzed. RESULTS: The mean value of S was 40 kBq/mL, S/B 
      ratio was 16, and THR was 26%. The THR correlated with S (r = -0.752), but no 
      correlation between THR and the S/B ratio was seen (r = -0.382). In 77% of cases, 
      S was >30 kBq/mL, and in 23% it was </=30 kBq/mL, with a mean THR of 21.4% and 
      41.6%, respectively (p < 0.001). Using PTV(PET) in radiotherapy treatment 
      planning resulted in a reduced PTV in 72% of cases, while covering 88.2% of 
      GTV(CT), comparable to the percentage of GTV(PET) covered by PTV(CT) (p = 0.15). 
      CONCLUSIONS: A case-specific PET signal threshold is optimal in PET-based 
      radiotherapy treatment planning. Signal gating using a THR of 20% in tumors with 
      S >30% +/- 1.6% kBq/mL and 40% in tumors with S </=30% +/- 1.6% kBq/mL is 
      suitable.
FAU - El-Bassiouni, Mazen
AU  - El-Bassiouni M
AD  - Department of Radiation Oncology, Zurich University Hospital, University of 
      Zurich, Zurich.
FAU - Ciernik, I Frank
AU  - Ciernik IF
FAU - Davis, J Bernard
AU  - Davis JB
FAU - El-Attar, Inas
AU  - El-Attar I
FAU - Reiner, Beatrice
AU  - Reiner B
FAU - Burger, Cyrill
AU  - Burger C
FAU - Goerres, Gerhard W
AU  - Goerres GW
FAU - Studer, Gabriela M
AU  - Studer GM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
RN  - 0 (Radiopharmaceuticals)
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Fluorodeoxyglucose F18
MH  - *Head and Neck Neoplasms/diagnostic imaging/radiotherapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Positron-Emission Tomography/*methods
MH  - Radiopharmaceuticals
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Tomography, X-Ray Computed/*methods
MH  - Tumor Burden
EDAT- 2007/08/21 09:00
MHDA- 2007/10/16 09:00
CRDT- 2007/08/21 09:00
PHST- 2006/09/13 00:00 [received]
PHST- 2007/04/30 00:00 [revised]
PHST- 2007/04/30 00:00 [accepted]
PHST- 2007/08/21 09:00 [pubmed]
PHST- 2007/10/16 09:00 [medline]
PHST- 2007/08/21 09:00 [entrez]
AID - S0360-3016(07)00803-6 [pii]
AID - 10.1016/j.ijrobp.2007.04.053 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2007 Sep 1;69(1):286-93. doi: 
      10.1016/j.ijrobp.2007.04.053.