Impact of suboptimal dosimetric coverage of pretherapeutic 18F-FDG PET/CT hotspots on outcome in patients with locally advanced cervical cancer treated with chemoradiotherapy followed by brachytherapy
| Autor: | Dorothy M Gujral, Ulrike Schick, Maelle Mauguen, V. Bourbonne, Ronan Abgral, Gurvan Dissaux, François Lucia, O. Miranda, Olivier Pradier |
|---|---|
| Přispěvatelé: | Imperial College London |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities cervical cancer medicine.medical_treatment [SDV]Life Sciences [q-bio] Brachytherapy genetic processes Locally advanced R895-920 information science urologic and male genital diseases Article 030218 nuclear medicine & medical imaging 03 medical and health sciences Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine Hotspot medicine Radiology Nuclear Medicine and imaging In patient PET/TDM RC254-282 Cervical cancer medicine.diagnostic_test business.industry Neoplasms. Tumors. Oncology. Including cancer and carcinogens food and beverages Image-guided medicine.disease 3. Good health Radiation therapy Oncology Positron emission tomography 030220 oncology & carcinogenesis Fdg pet ct Nuclear medicine business Chemoradiotherapy |
| Zdroj: | Clinical and Translational Radiation Oncology Clinical and Translational Radiation Oncology, Elsevier, 2020, 23, pp.50-59. ⟨10.1016/j.ctro.2020.05.004⟩ Clinical and Translational Radiation Oncology, Vol 23, Iss, Pp 50-59 (2020) |
| ISSN: | 2405-6308 |
| DOI: | 10.1016/j.ctro.2020.05.004⟩ |
| Popis: | Highlights • Hotspots can be easily identified on the pretherapeutic PET in patients with cervical cancer. • Registration of PET with planning CT allows for the dosimetric coverage evaluation of these hotspots. • The initial hotspot was not entirely included in the CTV-high risk in 40% of patients who recur during the follow-up, compared to 7% in patients without recurrence. • Hotspot was not entirely included in the CTV-high risk in 40% of patients who recur-Hotspots-guided radiotherapy could be applied easily in daily routine. Introduction Areas of high uptake on pre-treatment 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT), denoted as “hotspots”, have been identified as preferential sites of local relapse in locally advanced cervical cancer (LACC). The purpose of this study was to analyze the dosimetric coverage of these hotspots with high dose-rate brachytherapy (BT). Methods For each patient, a rigid registration of the CT from the pre-treatment PET/CT with the radiotherapy planning CT was performed using 3D SlicerTM, followed by a manual volume correction by translation and deformation if necessary. The fuzzy locally adaptive Bayesian (FLAB) algorithm was applied to PET images to simultaneously define an overall tumour volume and the high-uptake sub-volume V1. The inclusion of V1 in the high-risk clinical target volume (CTV HR) and its dosimetric coverage were evaluated using 3D SlicerTM. The average of the 3–4 BT sessions was reported. Results Forty-two patients with recurrence after chemoradiotherapy (CRT) for LACC were matched to 42 patients without recurrence. Mean ± standard deviation follow-up was 26 ± 11 months. In the recurrence group, V1 was not included in the CTV HR and not covered by the 85 Gy isodose in 17/42 patients (41%) (1/20 with pelvic recurrence and 16/22 with distant recurrence) and not by the 80 Gy isodose in 7/42 patients (17%) (all with distant recurrence). In the non-recurrence group, V1 was not included in CTV HR and not covered by the 85 Gy isodose in 3 patients only (7%). The hotspots coverage by the 85 Gy isodose was significantly better in patients who did not recur, but only when compared to patients with distant relapse (p |
| Databáze: | OpenAIRE |
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