PURPOSE: Fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) is more accurate than CT in determining the extent of non-small-cell lung cancer. We performed a study to evaluate the impact of FDG-PET/CT on the radiotherapy volume delineation compared with CT without using any mathematical algorithm and to correlate the findings with the pathologic examination findings. METHODS AND MATERIALS: A total of 32 patients with proven non-small-cell lung cancer, pathologic specimens from the mediastinum and lung primary, and pretreatment chest CT and FDG-PET/CT scans were studied. For each patient, two data sets of theoretical gross tumor volumes were contoured. One set was determined using the chest CT only, and the second, done separately, was based on the co-registered FDG-PET/CT data. The disease stage of each patient was determined using the TNM staging system for three data sets: the CT scan only, FDG-PET/CT scan, and pathologic findings. RESULTS: Pathologic examination altered the CT-determined stage in 22 (69%) of 32 patients and the PET-determined stage in 16 (50%) of 32 patients. The most significant alterations were related to the N stage. PET altered the TNM stage in 15 (44%) of 32 patients compared with CT alone, but only 7 of these 15 alterations were confirmed by the pathologic findings. With respect to contouring the tumor volume for radiotherapy, PET altered the contour in 18 (56%) of 32 cases compared with CT alone. CONCLUSION: The contour of the tumor volume of non-small-cell lung cancer patients with co-registered FDG-PET/CT resulted in >50% alterations compared with CT targeting, findings similar to those of other publications. However, the significance of this change is unknown. Furthermore, pathologic examination showed that PET is not always accurate and histologic examination should be obtained to confirm the findings of PET whenever possible.
PURPOSE: Fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) is more accurate than CT in determining the extent of non-small-cell lung cancer. We performed a study to evaluate the impact of FDG-PET/CT on the radiotherapy volume delineation compared with CT without using any mathematical algorithm and to correlate the findings with the pathologic examination findings. METHODS AND MATERIALS: A total of 32 patients with proven non-small-cell lung cancer, pathologic specimens from the mediastinum and lung primary, and pretreatment chest CT and FDG-PET/CT scans were studied. For each patient, two data sets of theoretical gross tumor volumes were contoured. One set was determined using the chest CT only, and the second, done separately, was based on the co-registered FDG-PET/CT data. The disease stage of each patient was determined using the TNM staging system for three data sets: the CT scan only, FDG-PET/CT scan, and pathologic findings. RESULTS: Pathologic examination altered the CT-determined stage in 22 (69%) of 32 patients and the PET-determined stage in 16 (50%) of 32 patients. The most significant alterations were related to the N stage. PET altered the TNM stage in 15 (44%) of 32 patients compared with CT alone, but only 7 of these 15 alterations were confirmed by the pathologic findings. With respect to contouring the tumor volume for radiotherapy, PET altered the contour in 18 (56%) of 32 cases compared with CT alone. CONCLUSION: The contour of the tumor volume of non-small-cell lung cancerpatients with co-registered FDG-PET/CT resulted in >50% alterations compared with CT targeting, findings similar to those of other publications. However, the significance of this change is unknown. Furthermore, pathologic examination showed that PET is not always accurate and histologic examination should be obtained to confirm the findings of PET whenever possible.
Authors: Antoni Vila; Alberto Sánchez-Reyes; Carles Conill; Juan Domingo Gispert; Carlos Trampal; Carmen Láinez; Jordi Vayreda; Agustí Pedro Journal: Clin Transl Oncol Date: 2010-05 Impact factor: 3.405
Authors: G F Persson; D E Nygaard; C Hollensen; P Munck af Rosenschöld; L S Mouritsen; A K Due; A K Berthelsen; J Nyman; E Markova; A P Roed; H Roed; S Korreman; L Specht Journal: Br J Radiol Date: 2012-09 Impact factor: 3.039
Authors: Chiang J Tyng; Rubens Chojniak; Paula N V Pinto; Marcelle A Borba; Almir G V Bitencourt; Ricardo C Fogaroli; Douglas G Castro; Paulo E Novaes Journal: Radiat Oncol Date: 2009-08-05 Impact factor: 3.481
Authors: Radovan Vojtíšek; Jan Mužík; Pavel Slampa; Marie Budíková; Jaroslav Hejsek; Petr Smolák; Jiří Ferda; Jindřich Fínek Journal: Rep Pract Oncol Radiother Date: 2013-10-17