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Title: Utilizing 18F-fluoroethyl-l-tyrosine positron emission tomography in high grade glioma for radiation treatment planning in patients with contraindications to MRI
Authors: Jayamanne, Dasantha ;Back, Michael ;Kaushal, Sneha ;Chan, D.L.;Schembri, G.;Brazier, D.;Bailey, D.;Wheeler, H.
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: Feb-2018
Source: 62(1):122-127
Journal title: Journal of Medical Imaging and Radiation Oncology
Department: Central Coast Cancer Centre
Radiation Oncology
Abstract: INTRODUCTION: Patients with high grade glioma (HGG) and contraindications to magnetic resonance imaging (MRI) are dependent on contrast-enhanced computerized tomography (CT) scan imaging for radiation therapy (RT) target volume delineation. This study reviews the experience with the utilization of 18F-fluoroethyl-l-tyrosine positron emission tomography (FET-PET) to define residual disease post craniotomy and optimize RT planning. METHODS: Patients with HGG and a contraindication to MRI managed with radiation therapy between 2007 and 2015 were identified. RT target volumes including gross tumour volume (GTV) defined by CT-alone and the biological target volume (BTV) defined by PET-CT were recorded. Clinical target volumes (CTV) were created from the GTV and BTV respectively using standard protocol volume expansion. The expanded BTV was termed clinical target volume biological (CTV-B). Union and intersection between CTV and CTV-B, conformity index, volumetric parameters and individual patient outcomes were analysed. RESULTS: Six patients fit study criteria. There was a mean increase in CTV-B from CTV by 31.6% with a conformity index of 0.78. Two out of six patients had FET-PET avid disease outside the constructed PTV when delineated by CT-alone. One patient with CT-only planning had a new contrast-enhancing mass within 1 month of completing RT, suggesting potential geographical miss. CONCLUSION: Patients with contraindication to MRI the addition of FET-PET can improve target volume delineation for RT Planning.
DOI: 10.1111/1754-9485.12676
ISSN: 1754-9477
Publicaton type: Journal Article
Keywords: Cancer
Appears in Collections:Oncology / Cancer

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