BACKGROUND AND PURPOSE: Modern radiotherapy (RT) techniques such as stereotactic RT, intensity-modulated RT, or particle irradiation allow local dose escalation with simultaneous sparing of critical organs. Several trials are currently investigating their benefit in glioma reirradiation and boost irradiation. Target volume definition is of critical importance especially when steep dose gradient techniques are employed. In this manuscript we investigate the impact of O-(2-(F-18)fluoroethyl)-l-tyrosine-positron emission tomography/computer tomography (FET-PET/CT) on target volume definition in low and high grade glioma patients undergoing either first or re-irradiation with particles. METHODS AND MATERIAL: We investigated volumetric size and uniformity of magnetic resonance imaging (MRI)- vs. FET-PET/CT-derived gross tumor volumes (GTVs) and planning target volumes (PTVs) of 41 glioma patients. Clinical cases are presented to demonstrate potential benefits of integrating FET-PET/CT-planning into daily routine. RESULTS: Integrating FET-uptake into the delineation of GTVs yields larger volumes. Combined modality-derived PTVs are significantly enlarged in high grade glioma patients and in case of primary RT. The congruence of MRI and FET signals for the identification of glioma GTVs is poor with mean uniformity indices of 0.39. MRI-based PTVs miss 17% of FET-PET/CT-based GTVs. Non significant alterations were detected in low grade glioma patients and in those undergoing reirradiation. CONCLUSIONS: Target volume definition for malignant gliomas during initial RT may yield significantly differing results depending upon the imaging modality, which the contouring process is based upon. The integration of both MRI and FET-PET/CT may help to improve GTV coverage by avoiding larger incongruences between physical and biological imaging techniques. In low grade gliomas and in cases of reirradiation, more studies are needed in order to investigate a potential benefit of FET-PET/CT for planning of RT.
BACKGROUND AND PURPOSE: Modern radiotherapy (RT) techniques such as stereotactic RT, intensity-modulated RT, or particle irradiation allow local dose escalation with simultaneous sparing of critical organs. Several trials are currently investigating their benefit in glioma reirradiation and boost irradiation. Target volume definition is of critical importance especially when steep dose gradient techniques are employed. In this manuscript we investigate the impact of O-(2-(F-18)fluoroethyl)-l-tyrosine-positron emission tomography/computer tomography (FET-PET/CT) on target volume definition in low and high grade gliomapatients undergoing either first or re-irradiation with particles. METHODS AND MATERIAL: We investigated volumetric size and uniformity of magnetic resonance imaging (MRI)- vs. FET-PET/CT-derived gross tumor volumes (GTVs) and planning target volumes (PTVs) of 41 gliomapatients. Clinical cases are presented to demonstrate potential benefits of integrating FET-PET/CT-planning into daily routine. RESULTS: Integrating FET-uptake into the delineation of GTVs yields larger volumes. Combined modality-derived PTVs are significantly enlarged in high grade gliomapatients and in case of primary RT. The congruence of MRI and FET signals for the identification of glioma GTVs is poor with mean uniformity indices of 0.39. MRI-based PTVs miss 17% of FET-PET/CT-based GTVs. Non significant alterations were detected in low grade gliomapatients and in those undergoing reirradiation. CONCLUSIONS: Target volume definition for malignant gliomas during initial RT may yield significantly differing results depending upon the imaging modality, which the contouring process is based upon. The integration of both MRI and FET-PET/CT may help to improve GTV coverage by avoiding larger incongruences between physical and biological imaging techniques. In low grade gliomas and in cases of reirradiation, more studies are needed in order to investigate a potential benefit of FET-PET/CT for planning of RT.
Authors: Robert H Press; Jim Zhong; Saumya S Gurbani; Brent D Weinberg; Bree R Eaton; Hyunsuk Shim; Hui-Kuo G Shu Journal: Neurosurgery Date: 2019-08-01 Impact factor: 4.654
Authors: Tim J Kruser; Walter R Bosch; Shahed N Badiyan; Joseph A Bovi; Amol J Ghia; Michelle M Kim; Abhishek A Solanki; Sean Sachdev; Christina Tsien; Tony J C Wang; Minesh P Mehta; Kevin P McMullen Journal: J Neurooncol Date: 2019-03-19 Impact factor: 4.130
Authors: Jana Lipkova; Panagiotis Angelikopoulos; Stephen Wu; Esther Alberts; Benedikt Wiestler; Christian Diehl; Christine Preibisch; Thomas Pyka; Stephanie E Combs; Panagiotis Hadjidoukas; Koen Van Leemput; Petros Koumoutsakos; John Lowengrub; Bjoern Menze Journal: IEEE Trans Med Imaging Date: 2019-02-27 Impact factor: 10.048