Faculty Collaboration Database

Initial experience of FDG-PET/CT guided IMRT of head-and-neck carcinoma. Int J Radiat Oncol Biol Phys 2006 May 01;65(1):143-51

Date

04/19/2006

Pubmed ID

16618577

DOI

10.1016/j.ijrobp.2005.11.048

Scopus ID

2-s2.0-33645964284 (requires institutional sign-in at Scopus site)   125 Citations

Abstract

PURPOSE: The purpose of this study is to evaluate the impact of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) fused with planning computed tomography (CT) on tumor localization, which guided intensity-modulated radiotherapy (IMRT) of patients with head-and-neck carcinoma.

METHODS AND MATERIALS: From October 2002 through April 2005, we performed FDG-PET/CT guided IMRT for 28 patients with head-and-neck carcinoma. Patients were immobilized with face masks that were attached with five fiducial markers. FDG-PET and planning CT scans were performed on the same flattop table in one session and were then fused. Target volumes and critical organs were contoured, and IMRT plans were generated based on the fused images.

RESULTS: All 28 patients had abnormal increased uptake in FDG-PET/CT scans. PET/CT resulted in CT-based staging changes in 16 of 28 (57%) patients. PET/CT fusions were successfully performed and were found to be accurate with the use of the two commercial planning systems. Volume analysis revealed that the PET/CT-based gross target volumes (GTVs) were significantly different from those contoured from the CT scans alone in 14 of 16 patients. In addition, 16 of 28 patients who were followed for more than 6 months did not have any evidence of locoregional recurrence in the median time of 17 months.

CONCLUSION: Fused images were found to be useful to delineate GTV required in IMRT planning. PET/CT should be considered for both initial staging and treatment planning in patients with head-and-neck carcinoma.

Author List

Wang D, Schultz CJ, Jursinic PA, Bialkowski M, Zhu XR, Brown WD, Rand SD, Michel MA, Campbell BH, Wong S, Li XA, Wilson JF

Authors

Bruce H. Campbell MD Emeritus Professor in the Otolaryngology department at Medical College of Wisconsin
Michelle A. Michel MD Adjunct Professor in the Radiology department at Medical College of Wisconsin
Christopher J. Schultz MD Chair, Professor in the Radiation Oncology department at Medical College of Wisconsin
Stuart J. Wong MD Center Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Female
Fluorodeoxyglucose F18
Head and Neck Neoplasms
Humans
Male
Middle Aged
Positron-Emission Tomography
Radiopharmaceuticals
Radiotherapy, Intensity-Modulated
Tomography, X-Ray Computed