Open Access18FDG-PET/CT Definition of Clinical Target Volume for Robotic Stereotactic Body Radiosurgery Treatment of Metastatic Gynecologic Malignancies
Author(s) -
Charles Kunos,
Robert Debernardo,
Jeffrey Fabien,
Donald Dobbins,
Yuxia Zhang,
James Brindle,
Peter Faulhaber
Publication year - 2011
Publication title -
journal of nuclear medicine and radiation therapy
Language(s) - English
Resource type - Journals
ISSN - 2155-9619
DOI - 10.4172/2155-9619.s4-001
Subject(s) - medicine , radiosurgery , nuclear medicine , radiology , radiation therapy
The objective of the current article was to evaluate 2-[ 18 F]fluoro-2-deoxy-D-glucose 18 F-FDG) as measured by positron emission tomography for delineation of abdominopelvic gross tumor volumes (GTV) for stereotactic body radiosurgery treatment (SBRT) of metastatic gynecologic cancers. A retrospective review of SBRT was conducted in 27 women with stage IV gynecologic cancers recurring in para-aortic lymph nodes. Robotic SBRT involved 2400 cGy in 3 consecutive 800 cGy daily fractions prescribed to a 3.0 mm expanded planning tumor volume (PTV) defined by both CT-based and 18 F-FDG-based GTVs. In this study, 18 F-FDG-based GTVs led to significantly larger PTVs in all 27 women, than if they had been based on CT GTVs alone ( P < 0.001). Enlarged PTVs may have resulted from the breathing-induced target motion during the time of 18 F-FDG image acquisition smearing 18 F-FDG signal over a greater anatomic dimension. Ultimately, SBRT-target local control, based on the RECIST 1.1 criteria, was 96% (26 of 27), and associated with minor reversible toxicity. The use of 18 F-FDG to define SBRT target volumes warrants further interrogation in SBRT clinical trials.