TY - JOUR
T1 - 18F FDG PET/ CT for planning external beam radiotherapy alters therapy in 11% of 581 patients
AU - Christensen, Charlotte Birk
AU - Jakobsen, Annika Ingeborg Loft
AU - Munck af Rosenschold, Per
AU - Højgaard, Liselotte
AU - Roed, Henrik
AU - Berthelsen, Anne Kiil
PY - 2018/3/1
Y1 - 2018/3/1
N2 - 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.
AB - 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.
U2 - 10.1111/cpf.12411
DO - 10.1111/cpf.12411
M3 - Journal article
C2 - 28168798
SN - 1475-0961
VL - 38
SP - 278
EP - 284
JO - Clinical Physiology and Functional Imaging
JF - Clinical Physiology and Functional Imaging
IS - 2
ER -