PMID- 23953407
OWN - NLM
STAT- MEDLINE
DCOM- 20141210
LR  - 20181202
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 109
IP  - 3
DP  - 2013 Dec
TI  - Analysis of FET-PET imaging for target volume definition in patients with gliomas 
      treated with conformal radiotherapy.
PG  - 487-92
LID - S0167-8140(13)00325-3 [pii]
LID - 10.1016/j.radonc.2013.06.043 [doi]
AB  - BACKGROUND AND PURPOSE: Modern radiotherapy (RT) techniques such as stereotactic 
      RT, intensity-modulated RT, or particle irradiation allow local dose escalation 
      with simultaneous sparing of critical organs. Several trials are currently 
      investigating their benefit in glioma reirradiation and boost irradiation. Target 
      volume definition is of critical importance especially when steep dose gradient 
      techniques are employed. In this manuscript we investigate the impact of 
      O-(2-(F-18)fluoroethyl)-l-tyrosine-positron emission tomography/computer 
      tomography (FET-PET/CT) on target volume definition in low and high grade glioma 
      patients undergoing either first or re-irradiation with particles. METHODS AND 
      MATERIAL: We investigated volumetric size and uniformity of magnetic resonance 
      imaging (MRI)- vs. FET-PET/CT-derived gross tumor volumes (GTVs) and planning 
      target volumes (PTVs) of 41 glioma patients. Clinical cases are presented to 
      demonstrate potential benefits of integrating FET-PET/CT-planning into daily 
      routine. RESULTS: Integrating FET-uptake into the delineation of GTVs yields 
      larger volumes. Combined modality-derived PTVs are significantly enlarged in high 
      grade glioma patients and in case of primary RT. The congruence of MRI and FET 
      signals for the identification of glioma GTVs is poor with mean uniformity 
      indices of 0.39. MRI-based PTVs miss 17% of FET-PET/CT-based GTVs. Non 
      significant alterations were detected in low grade glioma patients and in those 
      undergoing reirradiation. CONCLUSIONS: Target volume definition for malignant 
      gliomas during initial RT may yield significantly differing results depending 
      upon the imaging modality, which the contouring process is based upon. The 
      integration of both MRI and FET-PET/CT may help to improve GTV coverage by 
      avoiding larger incongruences between physical and biological imaging techniques. 
      In low grade gliomas and in cases of reirradiation, more studies are needed in 
      order to investigate a potential benefit of FET-PET/CT for planning of RT.
CI  - Copyright (c) 2013 Elsevier Ireland Ltd. All rights reserved.
FAU - Rieken, Stefan
AU  - Rieken S
AD  - University Hospital of Heidelberg, Department of Radiation Oncology, Germany. 
      Electronic address: Stefan.Rieken@med.uni-heidelberg.de.
FAU - Habermehl, Daniel
AU  - Habermehl D
FAU - Giesel, Frederik L
AU  - Giesel FL
FAU - Hoffmann, Christoph
AU  - Hoffmann C
FAU - Burger, Ute
AU  - Burger U
FAU - Rief, Harald
AU  - Rief H
FAU - Welzel, Thomas
AU  - Welzel T
FAU - Haberkorn, Uwe
AU  - Haberkorn U
FAU - Debus, Jurgen
AU  - Debus J
FAU - Combs, Stephanie E
AU  - Combs SE
LA  - eng
PT  - Journal Article
DEP - 20130813
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
RN  - 0 (O-(2-fluoroethyl)tyrosine)
RN  - 0 (Radiopharmaceuticals)
RN  - 42HK56048U (Tyrosine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Brain Neoplasms/*diagnostic imaging/pathology/*radiotherapy
MH  - Female
MH  - Glioma/*diagnostic imaging/pathology/*radiotherapy
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Multimodal Imaging/methods
MH  - Positron-Emission Tomography/methods
MH  - *Radiopharmaceuticals
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Conformal
MH  - Radiotherapy, Intensity-Modulated
MH  - Tomography, X-Ray Computed/methods
MH  - Tyrosine/*analogs & derivatives
MH  - Young Adult
OTO - NOTNLM
OT  - Boost irradiation
OT  - Delineation
OT  - FET
OT  - Glioma
OT  - Uniformity
EDAT- 2013/08/21 06:00
MHDA- 2014/12/15 06:00
CRDT- 2013/08/20 06:00
PHST- 2013/03/20 00:00 [received]
PHST- 2013/06/23 00:00 [revised]
PHST- 2013/06/24 00:00 [accepted]
PHST- 2013/08/20 06:00 [entrez]
PHST- 2013/08/21 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - S0167-8140(13)00325-3 [pii]
AID - 10.1016/j.radonc.2013.06.043 [doi]
PST - ppublish
SO  - Radiother Oncol. 2013 Dec;109(3):487-92. doi: 10.1016/j.radonc.2013.06.043. Epub 
      2013 Aug 13.