Jing Lu1, Xiang-Dong Sun2, Xi Yang1, Xin-Yu Tang1, Qin Qin1, Hong-Cheng Zhu1, Hong-Yan Cheng3, Xin-Chen Sun4. 1. Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China. 2. Department of Radiation Oncology, The 81st Hospital of PLA, Nanjing 210002, PR China. 3. Department of Synthetic Internal Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China. 4. Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China. Electronic address: sunxinchen2012@163.com.
Abstract
PURPOSE: With the advances in radiotracers, positron emission tomography/computed tomography (PET/CT) is recognized as a useful adjunct to anatomic imaging with CT, MRI and endoscopic ultrasonography (EUS). The objective of this review was to comprehensively analyze the roles of PET/CT for the radiotherapy of esophageal cancer. METHODS: In this review, we focused on issues concerning the application of PET/CT in TNM staging, target volume delineation and response to therapy, both for the primary tumor and regional lymph nodes. Furthermore, the following questions were addressed: how does PET/CT guide appropriate treatment protocols, how does it allow accurate tumor delineation and how does it guide prognosis and future treatment decisions. RESULTS AND CONCLUSION: For the staging of esophageal cancer, PET/CT played a crucial role in exploring distant malignant lymph nodes and metastasis with high sensitivity, specificity and accuracy. PET/CT using different radiotracer provided a serial of thresholding methods based on standardized uptake value (SUV) to assist in auto-contouring the gross tumor volume (GTV). The change in SUV may offer a potential paradigm of personalized treatment to definitive chemoradiotherapy (CRT). In total, PET/CT has sought to further optimize radiotherapy treatment planning for patients with esophageal cancer.
PURPOSE: With the advances in radiotracers, positron emission tomography/computed tomography (PET/CT) is recognized as a useful adjunct to anatomic imaging with CT, MRI and endoscopic ultrasonography (EUS). The objective of this review was to comprehensively analyze the roles of PET/CT for the radiotherapy of esophageal cancer. METHODS: In this review, we focused on issues concerning the application of PET/CT in TNM staging, target volume delineation and response to therapy, both for the primary tumor and regional lymph nodes. Furthermore, the following questions were addressed: how does PET/CT guide appropriate treatment protocols, how does it allow accurate tumor delineation and how does it guide prognosis and future treatment decisions. RESULTS AND CONCLUSION: For the staging of esophageal cancer, PET/CT played a crucial role in exploring distant malignant lymph nodes and metastasis with high sensitivity, specificity and accuracy. PET/CT using different radiotracer provided a serial of thresholding methods based on standardized uptake value (SUV) to assist in auto-contouring the gross tumor volume (GTV). The change in SUV may offer a potential paradigm of personalized treatment to definitive chemoradiotherapy (CRT). In total, PET/CT has sought to further optimize radiotherapy treatment planning for patients with esophageal cancer.
Authors: Francesco Giganti; Alessandro Ambrosi; Antonio Esposito; Alessandro Del Maschio; Francesco De Cobelli Journal: Br J Radiol Date: 2017-01-30 Impact factor: 3.039