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. 2012 Nov 17;17(6):298-318.
doi: 10.1016/j.rpor.2012.10.001. eCollection 2012.

Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on (18)F-FDG PET-CT for radiotherapy treatment planning

Cooperative Group for PET-CT in Radiotherapy Treatment Planning; Begoña Caballero Perea  1 , Antonio Cabrera Villegas  2 , José Miguel Delgado Rodríguez  3 , María José García Velloso  4 , Ana María García Vicente  5 , Carlos Huerga Cabrerizo  6 , Rosa Morera López  7 , Luis Alberto Pérez Romasanta  8 , Moisés Sáez Beltrán  9
Affiliations

Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on (18)F-FDG PET-CT for radiotherapy treatment planning

Cooperative Group for PET-CT in Radiotherapy Treatment Planning et al. Rep Pract Oncol Radiother. .

Abstract

Positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) is a valuable tool for diagnosing and staging malignant lesions. The fusion of PET and computed tomography (CT) yields images that contain both metabolic and morphological information, which, taken together, have improved the diagnostic precision of PET in oncology. The main imaging modality for planning radiotherapy treatment is CT. However, PET-CT is an emerging modality for use in planning treatments because it allows for more accurate treatment volume definition. The use of PET-CT for treatment planning is highly complex, and protocols and standards for its use are still being developed. It seems probable that PET-CT will eventually replace current CT-based planning methods, but this will require a full understanding of the relevant technical aspects of PET-CT planning. The aim of the present document is to review these technical aspects and to provide recommendations for clinical use of this imaging modality in the radiotherapy planning process.

Keywords: CT; Contouring; Delineation; PET; PET-CT; Radiotherapy planning.

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Figures

Fig. 1
Fig. 1
Schematic diagram of the radiotherapy process.
Fig. 2
Fig. 2
Absolute threshold = background + relative threshold (maximum signal – background).
Fig. 3
Fig. 3
Optimal threshold value depending on the shape.
Fig. 4
Fig. 4
Differences in delineating a real object at different threshold levels.
Fig. 5
Fig. 5
Partial volume effect.
Fig. 6
Fig. 6
Definition of the registration and fusion processes.
Fig. 7
Fig. 7
Dependence of the linear attenuation coefficient on photon energy. Figure created from data published by Hubbell and Seltzer.
Fig. 8
Fig. 8
Definition of the registration and fusion processes.
Fig. 9
Fig. 9
Dose rate at 10 cm and 1 m on average for 10 patients injected with approximately 370 MBq and at 60 min following injection.
Fig. 10
Fig. 10
Dose received by the patient at various stages during a PET/CT imaging study with contrast media.
See this image and copyright information in PMC

References

    1. Report 83. J ICRU. 2010;10(1) Oxford University Press. - PubMed
    1. Prescribing, recording and reporting photon beam therapy (supplement to ICRU report 50). ICRU report 62.
    1. Malicki J. The importance of accurate treatment planning, delivery, and dose verification. Rep Pract Onco Radiother. 2012;17(March (2)):63–65. - PMC - PubMed
    1. Facey K., Bradbury I., Laking G., Payne E. Overview of the clinical effectiveness of positron emission tomography imaging in selected cancers. Health Technol Assess. 2007;11(October (44)) iii–iv, xi–267. - PubMed
    1. Delbeke D., Schöder H., Martin W.H., Wahl R.L. Hybrid imaging (SPECT/CT and PET/CT): improving therapeutic decisions. Semin Nucl Med. 2009;39(September (5)):308–340. - PubMed

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