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. 2007 Jan 1;67(1):91-6.
doi: 10.1016/j.ijrobp.2006.08.017.

Adaptive brachytherapy treatment planning for cervical cancer using FDG-PET

Lilie L Lin  1 , Sasa Mutic, Daniel A Low, Richard LaForest, Milos Vicic, Imran Zoberi, Tom R Miller, Perry W Grigsby
Affiliations

Adaptive brachytherapy treatment planning for cervical cancer using FDG-PET

Lilie L Lin et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: A dosimetric study was conducted to compare intracavitary brachytherapy using both a conventional and a custom loading intended to cover a positron emission tomography (PET)-defined tumor volume in patients with cervix cancer.

Methods and materials: Eleven patients who underwent an [(18)F]-fluoro-deoxy-D-glucose (FDG)-PET in conjunction with their first, middle, or last brachytherapy treatment were included in this prospective study. A standard plan that delivers 6.5 Gy to point A under ideal conditions was compared with an optimized plan designed to conform the 6.5-Gy isodose surface to the PET defined volume.

Results: A total of 31 intracavitary brachytherapy treatments in conjunction with an FDG-PET were performed. The percent coverage of the target isodose surface for the first implant with and without optimization was 73% and 68% (p = 0.21). The percent coverage of the target isodose surface for the mid/final implant was 83% and 70% (p = 0.02), respectively. The dose to point A was higher with the optimized plans for both the first implant (p = 0.02) and the mid/last implants (p = 0.008). The dose to 2 cm(3) and 5 cm(3) of both the bladder and rectum were not significantly different.

Conclusions: FDG-PET based treatment planning allowed for improved dose coverage of the tumor without significantly increasing the dose to the bladder and rectum.

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