PURPOSE: Our aim was to compare computed tomography (CT) and coregistered [(18)F]-fluorodeoxyglucose positron emission tomography CT-(FDG-PET/CT) based delineation of gross tumor volume (GTV) in unresectable colorectal liver metastasis (CRLM). MATERIALS AND METHODS: Fifty-four patients with unresectable CRLM were enrolled but 16 were excluded due to detection of additional hepatic metastases in ten on PET/CT scans, precluding radiotherapy because of transcendent critical organ doses beyond tolerable limits; and of extrahepatic metastases in six. For 38 eligible patients, both CT and PET/CT images were acquired, and two 3D conformal plans were made using the CT and FDG-PET/CT fusion data sets. Radiotherapy plans (RTP) and doses to critical organs were analyzed. RESULTS: Comparisons between two RTPs revealed need for change in GTV in 31 of 38 analyzable patients (81.6 %). In 25 (65.8 %) patients, GTV was significantly increased, with a median of 33.2 % (p < 0.001), whereas median 12.8 % decrease in six (15.8 %) (p < 0.001). There were no clinically meaningful differences in critical organ doses. CONCLUSION: Coregistered FDG-PET/CT may improve delineation of GTV and theoretically reduce the likelihood of geographic misses in unresectable CRLM. Additionally, integration of FDG-PET/CT in the initial assessments of CRLM may spare almost one third of patients from potentially futile radical interventions.
PURPOSE: Our aim was to compare computed tomography (CT) and coregistered [(18)F]-fluorodeoxyglucose positron emission tomography CT-(FDG-PET/CT) based delineation of gross tumor volume (GTV) in unresectable colorectal liver metastasis (CRLM). MATERIALS AND METHODS: Fifty-four patients with unresectable CRLM were enrolled but 16 were excluded due to detection of additional hepatic metastases in ten on PET/CT scans, precluding radiotherapy because of transcendent critical organ doses beyond tolerable limits; and of extrahepatic metastases in six. For 38 eligible patients, both CT and PET/CT images were acquired, and two 3D conformal plans were made using the CT and FDG-PET/CT fusion data sets. Radiotherapy plans (RTP) and doses to critical organs were analyzed. RESULTS: Comparisons between two RTPs revealed need for change in GTV in 31 of 38 analyzable patients (81.6 %). In 25 (65.8 %) patients, GTV was significantly increased, with a median of 33.2 % (p < 0.001), whereas median 12.8 % decrease in six (15.8 %) (p < 0.001). There were no clinically meaningful differences in critical organ doses. CONCLUSION: Coregistered FDG-PET/CT may improve delineation of GTV and theoretically reduce the likelihood of geographic misses in unresectable CRLM. Additionally, integration of FDG-PET/CT in the initial assessments of CRLM may spare almost one third of patients from potentially futile radical interventions.
Authors: Pier Paolo Mainenti; Marcello Mancini; Ciro Mainolfi; Luigi Camera; Simone Maurea; Antonietta Manchia; Michela Tanga; Francesco Persico; Pietro Addeo; Dario D'Antonio; Antonio Speranza; Luigi Bucci; Giovanni Persico; Leonardo Pace; Marco Salvatore Journal: Abdom Imaging Date: 2009-06-27
Authors: T S Lawrence; R K Ten Haken; M L Kessler; J M Robertson; J T Lyman; M L Lavigne; M B Brown; D J DuRoss; J C Andrews; W D Ensminger Journal: Int J Radiat Oncol Biol Phys Date: 1992 Impact factor: 7.038
Authors: J M Robertson; T S Lawrence; L M Dworzanin; J C Andrews; S Walker; M L Kessler; D J DuRoss; W D Ensminger Journal: J Clin Oncol Date: 1993-07 Impact factor: 44.544
Authors: Julian Mm Rogasch; Ingo G Steffen; Frank Hofheinz; Oliver S Großer; Christian Furth; Konrad Mohnike; Peter Hass; Mathias Walke; Ivayla Apostolova; Holger Amthauer Journal: EJNMMI Res Date: 2015-05-06 Impact factor: 3.138