Challenges in using 18 F-fluorodeoxyglucose-PET-CT to define a biological radiotherapy boost volume in locally advanced pancreatic cancer

Radiation Oncology

Maria Hawkins¹  Mike Partridge¹  Thomas B Brunner²  Kwun-Ye Chu¹  Somnath Mukherjee¹  James M Wilson¹ 

[1] CRUK/MRC Oxford Institute for Radiation Oncology, Gray Laboratories, University of Oxford, Old Road Campus Research Building, Off Roosevelt Drive, Oxford OX3 7DQ, UK;Department of Radiation Oncology, University Hospitals of Freiburg, Robert-Koch-Str. 3, D-79106 Freiburg im Breisgau, Germany

关键词: Biological target volume;    Intra-tumour heterogeneity;    Residual metabolic activity;    PET-CT;    Pancreatic cancer;   

Others  :  800943
DOI  :  10.1186/1748-717X-9-146

 received in 2014-03-07, accepted in 2014-06-10,  发布年份 2014

【 摘 要 】

Background

The best method of identifying regions within pancreatic tumours that might benefit from an increased radiotherapy dose is not known. We investigated the utility of pre-treatment FDG-PET in predicting the spatial distribution of residual metabolic activity following chemoradiotherapy (CRT) in locally advanced pancreatic cancer (LAPC).

Methods

17 patients had FDG-PET/CT scans at baseline and six weeks post-CRT. Tumour segmentation was performed at 40% and 50% of SUV_max at baseline and 60%, 70%, 80% and 90% post-CRT. FDG-PET scans were non-rigidly registered to the radiotherapy planning CT using the CT component of the FDG-PET/CT. Percentage overlap of the post-CRT volumes with the pre-CRT volumes with one another and the gross tumour volume (GTV) was calculated.

Results

SUV_max decreased during CRT (median pre- 8.0 and post- 3.6, p < 0.0001). For spatial correlation analysis, 9 pairs of scans were included (Four were excluded following complete metabolic response, one patient had a non-FDG avid tumour, one had no post-CRT imaging, one had diffuse FDG uptake that could not be separated from normal tissues and one had an elevated blood glucose). The Pre40% and 50% of SUVmax volumes covered a mean of 50.8% and 30.3% of the GTV respectively. The mean% overlap of the 90%, 80%, 70%, 60% of SUVmax post-CRT with the Pre40% and Pre50% volumes were 83.3%, 84.0%, 83.7%, 77.9% and 77.8%, 69.9%, 74.5%, 64.8% respectively.

Conclusions

Regions of residual metabolic activity following CRT can be predicted from the baseline FDG-PET and could aid definition of a biological target volume for non-uniform dose prescriptions.

【 授权许可】

   
2014 Wilson et al.; licensee BioMed Central Ltd.

【 图 表 】

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