PET for radiotherapy planning
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PET for radiotherapy planning. / Dejanovic, Danijela; Specht, Lena; Munk, Ole Lajord; Christensen, Charlotte Birk; Berthelsen, Anne Kiil; Law, Ian; Loft, Annika.
Nuclear Medicine and Molecular Imaging: Volume 1-4. Vol. 3 Elsevier, 2022. p. 774-792.Research output: Chapter in Book/Report/Conference proceeding › Book chapter › Research › peer-review
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TY - CHAP
T1 - PET for radiotherapy planning
AU - Dejanovic, Danijela
AU - Specht, Lena
AU - Munk, Ole Lajord
AU - Christensen, Charlotte Birk
AU - Berthelsen, Anne Kiil
AU - Law, Ian
AU - Loft, Annika
N1 - Publisher Copyright: © 2022 Elsevier Inc. All rights reserved.
PY - 2022
Y1 - 2022
N2 - To benefit from modern radiation therapy characterized by highly conformal dose distribution and steep dose gradients, high quality imaging is required for precise tumor delineation. The standard imaging for radiation therapy planning (RTP) remains the acquisition of a dedicated planning computed tomography (CT). Recent advances in combined functional and structural imaging, e.g. hybrid positron emission tomography and CT (PET/CT) have led to progress in management of cancer patients. As PET/CT has become widely available it is increasingly being incorporated into routine RTP. PET/CT in RTP is a multidisciplinary task involving the expertise in radiation oncology, radiology, nuclear medicine and medical physics. Imaging protocols and tumor delineation methods for PET/CT in RT planning should be well-defined and rigorously applied to guarantee reproducibility. The most often used radiotracer for PET/CT in RTP is the glucose analog [18F]FDG, depicting cell metabolism with high sensitivity but low specificity as it is not a specific tumor tracer. PET-based RTP can improve local tumor control by reducing target volume and using dose escalation, with fewer side effects by restricting RT to [18F]FDG avid volumes. Applications of functional imaging are continuously evolving with development of novel PET tracers aimed at specific biological processes. As personalized medicine has become a true force in modern medicine, the individualization of treatment strategies in RTP will require functional imaging in the tailoring of RT for each patient. Novel approaches in radiation therapy delivery, such as dose painting using PET/CT, have been suggested as methods to reduce risk of local recurrence. Equally important, is minimizing radiation toxicity to normal tissue by using PET/CT with breath hold techniques. Furthermore, PET/CT is increasingly used to predict and evaluate response to RT to optimize treatment strategy.
AB - To benefit from modern radiation therapy characterized by highly conformal dose distribution and steep dose gradients, high quality imaging is required for precise tumor delineation. The standard imaging for radiation therapy planning (RTP) remains the acquisition of a dedicated planning computed tomography (CT). Recent advances in combined functional and structural imaging, e.g. hybrid positron emission tomography and CT (PET/CT) have led to progress in management of cancer patients. As PET/CT has become widely available it is increasingly being incorporated into routine RTP. PET/CT in RTP is a multidisciplinary task involving the expertise in radiation oncology, radiology, nuclear medicine and medical physics. Imaging protocols and tumor delineation methods for PET/CT in RT planning should be well-defined and rigorously applied to guarantee reproducibility. The most often used radiotracer for PET/CT in RTP is the glucose analog [18F]FDG, depicting cell metabolism with high sensitivity but low specificity as it is not a specific tumor tracer. PET-based RTP can improve local tumor control by reducing target volume and using dose escalation, with fewer side effects by restricting RT to [18F]FDG avid volumes. Applications of functional imaging are continuously evolving with development of novel PET tracers aimed at specific biological processes. As personalized medicine has become a true force in modern medicine, the individualization of treatment strategies in RTP will require functional imaging in the tailoring of RT for each patient. Novel approaches in radiation therapy delivery, such as dose painting using PET/CT, have been suggested as methods to reduce risk of local recurrence. Equally important, is minimizing radiation toxicity to normal tissue by using PET/CT with breath hold techniques. Furthermore, PET/CT is increasingly used to predict and evaluate response to RT to optimize treatment strategy.
KW - DIBH
KW - Dose painting
KW - FDG
KW - GTV
KW - Image reconstruction
KW - IMRT
KW - PET/CT
KW - Radiation therapy
KW - Tumor delineation
U2 - 10.1016/B978-0-12-822960-6.00128-9
DO - 10.1016/B978-0-12-822960-6.00128-9
M3 - Book chapter
AN - SCOPUS:85151225166
SN - 9780128229606
VL - 3
SP - 774
EP - 792
BT - Nuclear Medicine and Molecular Imaging
PB - Elsevier
ER -
ID: 345055290