18F FDG PET/ CT for planning external beam radiotherapy alters therapy in 11% of 581 patients

Charlotte Birk Christensen, Annika Ingeborg Loft Jakobsen, Per Munck af Rosenschold, Liselotte Højgaard, Henrik Roed, Anne Kiil Berthelsen

4 Citationer (Scopus)

Abstract

Background: 18F-FDG PET/CT (FDG PET/CT) used in radiotherapy planning for extra-cerebral malignancy may reveal metastases to distant sites that may affect the choice of therapy. Aim: To investigate the role of FDG PET/CT on treatment strategy changes induced by the use of PET/CT as part of the radiotherapy planning. ‘A major change of treatment strategy’ was defined as either including more lesions in the gross tumour volume (GTV) distant from the primary tumour or a change in treatment modalities. Methods: The study includes 581 consecutive patients who underwent an FDG PET/CT scan for radiotherapy planning in our institution in the year 2008. All PET/CT scans were performed with the patient in treatment position with the use of immobilization devices according to the intended radiotherapy treatment. All scans were evaluated by a nuclear medicine physician together with a radiologist to delineate PET-positive GTV (GTV-PET). Results: For 63 of the patients (11%), the PET/CT simulation scans resulted in a major change in treatment strategy because of the additional diagnostic information. Changes were most frequently observed in patients with lung cancer (20%) or upper gastrointestinal cancer (12%). In 65% of the patients for whom the PET/CT simulation scan revealed unexpected dissemination, radiotherapy was given – changed (n = 38) or unchanged (n = 13) according to the findings on the FDG PET/CT. Conclusion: Unexpected dissemination on the FDG PET/CT scanning performed for radiotherapy planning caused a change in treatment strategy in 11% of 581 patients.

OriginalsprogEngelsk
TidsskriftClinical Physiology and Functional Imaging
Vol/bind38
Udgave nummer2
Sider (fra-til)278-284
ISSN1475-0961
DOI
StatusUdgivet - 1 mar. 2018

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