Respiratory-gated (4D) contrast-enhanced FDG PET-CT for radiotherapy planning of lower oesophageal carcinoma: feasibility and impact on planning target volume

BMC Cancer

Research Article

Robin Prestwich¹  Patrick Murray¹  Rebecca Goody¹  Gillian Ward²  Garry McDermott³  Karen Marshall⁴  Andrew Scarsbrook⁵  Ganesh Radhakrishna⁶ 

[1] Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Level 1, Bexley Wing, Beckett Street, LS9 7TF, Leeds, UK;Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Level 1, Bexley Wing, Beckett Street, LS9 7TF, Leeds, UK;Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Level 1, Bexley Wing, Beckett Street, LS9 7TF, Leeds, UK;Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK;The Christie Hospital, Wilmslow Road, M20 4 BX, Manchester, UK;

关键词: FDG pet-Ct;    Oesophageal carcinoma;    Radiotherapy treatment planning;    Four-dimensional CT;    Target volume definition;   

DOI  :  10.1186/s12885-017-3659-9

 received in 2017-03-25, accepted in 2017-09-27,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTo assess the feasibility and potential impact on target delineation of respiratory-gated (4D) contrast-enhanced 18Fluorine fluorodeoxyglucose (FDG) positron emission tomography - computed tomography (PET-CT), in the treatment planning position, for a prospective cohort of patients with lower third oesophageal cancer.MethodsFifteen patients were recruited into the study. Imaging included 4D PET-CT, 3D PET-CT, endoscopic ultrasound and planning 4D CT. Target volume delineation was performed on 4D CT, 4D CT with co-registered 3D PET and 4D PET-CT. Planning target volumes (PTV) generated with 4D CT (PTV4DCT), 4D CT co-registered with 3D PET-CT (PTV3DPET4DCT) and 4D PET-CT (PTV4DPETCT) were compared with multiple positional metrics.ResultsMean PTV4DCT, PTV3DPET4DCT and PTV4DPETCT were 582.4 ± 275.1 cm3, 472.5 ± 193.1 cm3 and 480.6 ± 236.9 cm3 respectively (no significant difference). Median DICE similarity coefficients comparing PTV4DCT with PTV3DPET4DCT, PTV4DCT with PTV4DPETCT and PTV3DPET4DCT with PTV4DPETCT were 0.85 (range 0.65–0.9), 0.85 (range 0.69–0.9) and 0.88 (range 0.79–0.9) respectively. The median sensitivity index for overlap comparing PTV4DCT with PTV3DPET4DCT, PTV4DCT with PTV4DPETCT and PTV3DPET4DCT with PTV4DPETCT were 0.78 (range 0.65–0.9), 0.79 (range 0.65–0.9) and 0.89 (range 0.68–0.94) respectively.ConclusionsPlanning 4D PET-CT is feasible with careful patient selection. PTV generated using 4D CT, 3D PET-CT and 4D PET-CT were of similar volume, however, overlap analysis demonstrated that approximately 20% of PTV3DPETCT and PTV4DPETCT are not included in PTV4DCT, leading to under-coverage of target volume and a potential geometric miss. Additionally, differences between PTV3DPET4DCT and PTV4DPETCT suggest a potential benefit for 4D PET-CT.Trial registrationClinicalTrials.gov Identifier – NCT02285660 (Registered 21/10/2014).

【 授权许可】

CC BY   
© The Author(s). 2017