F-18 FDG PET-CT Influences Target Delineation When Combined With Standard CT-Based Radiotherapy Planning in the Palliative Setting in Malignant Pleural Mesothelioma; an Exploratory Study

  • Nicholas Mac Leod Beatson West of Scotland Cancer Centre
  • Jon Stobo
  • Noelle O’Rourke
  • Jonathan Hicks
  • Karen Moore
  • Marimuthu Sankaralingam
  • Kurian Oommen
  • Caroline Kelly
  • Lynn McMahon
  • Fat Wi Poon
  • Sai Han
  • Caroline Findlay
  • Anthony Chalmers
  • Marie Fallon
  • Barry J Laird
Keywords: Positron Emission Tomography Computerized Tomography (PET-CT) Radiotherapy Mesothelioma

Abstract

Background:

Positron emission tomography computerized tomography (PET-CT) is useful in radiotherapy planning for lung cancer. However, its role in malignant pleural mesothelioma (MPM) is unknown.

Objectives:

This exploratory study investigated the possible role for PET-CT in radiotherapy planning for MPM.

Patients and Methods:

Patients receiving radiotherapy for the treatment of pain in MPM, had fluorodeoxyglucose (FDG) PET-CT scanning in addition to their standard CT scan. PET-CT images were then fused with CT planning images, termed Planning-PET-CT. Target volume delineation was undertaken first using CT and subsequently incorporated Planning-PET-CT. Planning treatment volume (PTV), conformity index (CI), mean distance to conformity (MDC), center of gravity distance (CGD) and standard uptake values (SUV) were examined.

Results:

Sixteen patients were recruited into the study. PET-CT upstaged nine patients. No association between SUV max and either survival or pain response was seen. Volumes contoured using Planning-PET-CT differed markedly from those outlined using CT alone as shown by the following parameters: CI = 0.3 (0.24 - 0.38). MDC = 21.47 (16.73 - 33.70) and CGD = 16.40 (11.80 - 33.87). The median percentage of over contouring was 44.00% (34.33 - 72.50) with 46.67% under contoured (34.00 - 55.00).

Conclusions:

PET-CT alters the position of the PTV in MPM and upstaged a proportion of patients. Further work to elucidate the role of Planning-PET-CT in target volume definition is justified.

Published
2015-06-12
How to Cite
Mac Leod, N., Stobo, J., O’Rourke, N., Hicks, J., Moore, K., Sankaralingam, M., Oommen, K., Kelly, C., McMahon, L., Wi Poon, F., Han, S., Findlay, C., Chalmers, A., Fallon, M., & Laird, B. J. (2015). F-18 FDG PET-CT Influences Target Delineation When Combined With Standard CT-Based Radiotherapy Planning in the Palliative Setting in Malignant Pleural Mesothelioma; an Exploratory Study. Reports of Radiotherapy and Oncology, 2(2), 24-28. Retrieved from http://waocp.com/journal/index.php/Reports-of-Radiotherapy-and-Onco/article/view/2349
Issue
Vol 2 No 2 (2015)
Section
Articles