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

doi:10.1111/cpf.12411

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 Citations (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.

Original language	English
Journal	Clinical Physiology and Functional Imaging
Volume	38
Issue number	2
Pages (from-to)	278-284
ISSN	1475-0961
DOIs	https://doi.org/10.1111/cpf.12411
Publication status	Published - 1 Mar 2018

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@article{ad7a963219bc474c9b4930c350fb0dac,

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

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. {\textquoteleft}A major change of treatment strategy{\textquoteright} 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.",

author = "Christensen, {Charlotte Birk} and Jakobsen, {Annika Ingeborg Loft} and {Munck af Rosenschold}, Per and Liselotte H{\o}jgaard and Henrik Roed and Berthelsen, {Anne Kiil}",

year = "2018",

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doi = "10.1111/cpf.12411",

language = "English",

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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.

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