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Utilizing 18F‐fluoroethyl‐ l ‐tyrosine positron emission tomography in high grade glioma for radiation treatment planning in patients with contraindications to MRI
Author(s) -
Jaymanne Dasantha T,
Kaushal Sneha,
Chan David,
Schembri Geoff,
Brazier David,
Bailey Dale,
Wheeler Helen,
Back Michael
Publication year - 2018
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12676
Subject(s) - medicine , contraindication , positron emission tomography , magnetic resonance imaging , nuclear medicine , radiation therapy , radiation treatment planning , glioma , radiology , pathology , alternative medicine , cancer research
Abstract Introduction Patients with high grade glioma ( HGG ) and contraindications to magnetic resonance imaging ( MRI ) are dependent on contrast‐enhanced computerized tomography ( CT ) scan imaging for radiation therapy ( RT ) target volume delineation. This study reviews the experience with the utilization of 18F‐fluoroethyl‐ l ‐tyrosine positron emission tomography ( FET ‐ PET ) to define residual disease post craniotomy and optimize RT planning. Methods Patients with HGG and a contraindication to MRI managed with radiation therapy between 2007 and 2015 were identified. RT target volumes including gross tumour volume ( GTV ) defined by CT ‐alone and the biological target volume ( BTV ) defined by PET ‐ CT were recorded. Clinical target volumes ( CTV ) were created from the GTV and BTV respectively using standard protocol volume expansion. The expanded BTV was termed clinical target volume biological ( CTV ‐B). Union and intersection between CTV and CTV ‐B, conformity index, volumetric parameters and individual patient outcomes were analysed. Results Six patients fit study criteria. There was a mean increase in CTV ‐B from CTV by 31.6% with a conformity index of 0.78. Two out of six patients had FET ‐ PET avid disease outside the constructed PTV when delineated by CT ‐alone. One patient with CT ‐only planning had a new contrast‐enhancing mass within 1 month of completing RT , suggesting potential geographical miss. Conclusion Patients with contraindication to MRI the addition of FET ‐ PET can improve target volume delineation for RT Planning.