BACKGROUND AND PURPOSE: To evaluate the input of FDG-PET data in the implementation of the involved-node radiotherapy concept and dose painting. MATERIALS AND METHODS: Patients with early-stage Hodgkin lymphoma treated with combined modality treatments. First, patients underwent a PET/CT before chemotherapy in the treatment position using a head and shoulder immobilization mask. Second, all patients had a CT simulation for treatment planning. The CT simulation was coregistered with the prechemotherapy CT and FDG-PET scan. All prechemotherapy volumes were superimposed on the CT simulation. The initially involved lymph node areas to be irradiated were delineated on the CT simulation scan. Chemotherapy-induced shrinkage rates of the tumor masses visible on CT scan and on FDG-PET were determined and compared. RESULTS: Before chemotherapy, FDG-PET-avid areas represented 25% of the total volume on CT. After chemotherapy, the influence of initial FDG-PET data on the delineation of involved-node radiotherapy fields was significant and was due to the fact that in 36% of the patients, FDG-PET helped pinpoint lymph nodes that were undetected on CT. After chemotherapy, the rates of tumor volume shrinkage on CT and FDG-PET were similar. This finding suggests similar chemosensitivity for FDG-PET-avid and non-avid areas. There was no correlation between initial FDG-PET-avid volumes and the clinical outcome. CONCLUSION: Prechemotherapy FDG-PET data are essential for correctly implementing the involved-node radiotherapy concept but seem to be of minimal value for applying the concept of dose painting.
BACKGROUND AND PURPOSE: To evaluate the input of FDG-PET data in the implementation of the involved-node radiotherapy concept and dose painting. MATERIALS AND METHODS:Patients with early-stage Hodgkin lymphoma treated with combined modality treatments. First, patients underwent a PET/CT before chemotherapy in the treatment position using a head and shoulder immobilization mask. Second, all patients had a CT simulation for treatment planning. The CT simulation was coregistered with the prechemotherapy CT and FDG-PET scan. All prechemotherapy volumes were superimposed on the CT simulation. The initially involved lymph node areas to be irradiated were delineated on the CT simulation scan. Chemotherapy-induced shrinkage rates of the tumor masses visible on CT scan and on FDG-PET were determined and compared. RESULTS: Before chemotherapy, FDG-PET-avid areas represented 25% of the total volume on CT. After chemotherapy, the influence of initial FDG-PET data on the delineation of involved-node radiotherapy fields was significant and was due to the fact that in 36% of the patients, FDG-PET helped pinpoint lymph nodes that were undetected on CT. After chemotherapy, the rates of tumor volume shrinkage on CT and FDG-PET were similar. This finding suggests similar chemosensitivity for FDG-PET-avid and non-avid areas. There was no correlation between initial FDG-PET-avid volumes and the clinical outcome. CONCLUSION: Prechemotherapy FDG-PET data are essential for correctly implementing the involved-node radiotherapy concept but seem to be of minimal value for applying the concept of dose painting.
Authors: R A Bundschuh; N Andratschke; J Dinges; M N Duma; S T Astner; M Brügel; S I Ziegler; M Molls; M Schwaiger; M Essler Journal: Strahlenther Onkol Date: 2012-03-24 Impact factor: 3.621
Authors: Guido Lammering; Dirk De Ruysscher; Angela van Baardwijk; Brigitta G Baumert; Jacques Borger; Ludy Lutgens; Piet van den Ende; Michel Ollers; Philippe Lambin Journal: Strahlenther Onkol Date: 2010-08-30 Impact factor: 3.621