THE ROLE OF PET AND PET/CT IN RADIATION THERAPY PLANNING PROCESS

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SEILANIAN TOUSSI MEHDI; SHAHID SALES SUDABEH

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Journal Paper

Paper Information

Journal: Iranian Journal of Nuclear Medicine Year:2010 | Volume:18 | Issue:SUPPLEMENT 1 Page(s): 23-23

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Title

THE ROLE OF PET AND PET/CT IN RADIATION THERAPY PLANNING PROCESS

Author(s)

SEILANIAN TOUSSI MEHDI | SHAHID SALES SUDABEH

Keywords

PET SCAN

CT SCAN

RADIOTHERAPY

RADIOTHERAPY PLANNING

Abstract

Radiation therapy has a major role in treatment of malignant tumor not only as an adjuvant treatment for surgery but also as a primary modality in treatment of inoperable tumors or as an alternative to surgery in order to preserve organ function and/or avoiding surgical complications.Treatment planning has evolved from simple conventional planning to conformal techniques such as Three-Dimentional conformal radiation therapy and intensity Modulated Radiation Therapy (IMRT). These techniques which are based on anatomical information from CT SCAN or MRI allow us to confirm radiation dose distribution to the target volume with a minimum possible dose to normal tissues. A major step in planning process is delineating tumor bearing tissues (target volume). The most important limitation is that the extent of target volume is not always discernible based on CT SCAN or MRI information.Positron emission tomography (PET) usingradioactive fluorine-18 labelled FDG as a tracer enables biological imaging of tumors and highlights its proliferating areas. This imaging technique which has an important role in diagnosis, staging and restaging of tumors has been introduced in radiation planning to facilitate tumor delineation. By using the same table and positioning for a PET / CT SCAN it is possible to fuse both images and combine the physiologic information from PET and superior images of anatomy and localization from CT SCAN. Using PET / CT SCAN in RADIOTHERAPY planning has the following potential advantages: 1- Differentiating between tumor and normal tissue. Take for an example; in lung cancer a distal atelectasis could be mixed up with a central tumor in CT SCAN.2- Including the tumor spread such as metastatic lymph nodes into the target volume which could be missed in CT information.3- Assessing the tumor response after terminating the planned treatment and prescribing additional boost dose to the remaining functional area.4- In some organs such as lung which lesions move considerably during respiration and RADIOTHERAPY, acquiring gated 4-D PET SCAN and hybrid PET / CT make it possible to assess the tumor motion precisely and allowing tighten tumor margins.In non-small cell lung cancer using FDG-PET has resulted in safe decrease in RADIOTHERAPY volume in a considerable number of patients and allowed dose escalation in tumor. In esophageal and Head and neck carcinoma it is possible to detect unrecognized lymph node metastasis and to delineate the tumor volume more precisely. In Hodgkin’s lymphoma, PET may be essential in involved field RADIOTHERAPY after chemotherapy to safely decrease the treatment volume while avoiding geographic miss. In cervical carcinoma PET can help a clinician to decide whether to encompass the para-aortic lymph nodes in treatment volume or not. PET has also an emerging role in RADIOTHERAPY of primary brain tumors.Multiple studies suggest an increasingly important role for PET in RADIOTHERAPY planning. However, using PET should follow strict standardized protocols. Further investigations are needed to reveal its exact role in radiation planning for different malignancies and to define safe recommendations.

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APA: Copy

SEILANIAN TOUSSI, MEHDI, & SHAHID SALES, SUDABEH. (2010). THE ROLE OF PET AND PET/CT IN RADIATION THERAPY PLANNING PROCESS. IRANIAN JOURNAL OF NUCLEAR MEDICINE, 18(SUPPLEMENT 1), 23-23. SID. https://sid.ir/paper/570519/en

Vancouver: Copy

SEILANIAN TOUSSI MEHDI, SHAHID SALES SUDABEH. THE ROLE OF PET AND PET/CT IN RADIATION THERAPY PLANNING PROCESS. IRANIAN JOURNAL OF NUCLEAR MEDICINE[Internet]. 2010;18(SUPPLEMENT 1):23-23. Available from: https://sid.ir/paper/570519/en

IEEE: Copy

MEHDI SEILANIAN TOUSSI, and SUDABEH SHAHID SALES, “THE ROLE OF PET AND PET/CT IN RADIATION THERAPY PLANNING PROCESS,” IRANIAN JOURNAL OF NUCLEAR MEDICINE, vol. 18, no. SUPPLEMENT 1, pp. 23–23, 2010, [Online]. Available: https://sid.ir/paper/570519/en

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