scholarly journals Dose-painted volumetric modulated arc therapy of high-grade glioma using 3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine positron emission tomography

2019 ◽  
Vol 92 (1099) ◽  
pp. 20180901 ◽  
Author(s):  
Robert Kosztyla ◽  
Srinivas Raman ◽  
Vitali Moiseenko ◽  
Stefan A Reinsberg ◽  
Brian Toyota ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Volumetric Modulated Arc Therapy ◽  
Target Volume ◽  
Emission Tomography ◽  
High Grade ◽  
Dose Painting ◽  
Positron Emission ◽  
Pet Ct ◽  
Arc Therapy ◽  
High Grade Gliomas

Objective: To determine whether dose painting with volumetric modulated arc therapy for high-grade gliomas using 3,4-dihydroxy-6-[18F]fluoro-l-phenylalanine (18F-FDOPA) positron emission tomography (PET) could achieve dose-escalated coverage of biological target volumes (BTVs) without increasing the dose to cranial organs at risk (OARs). Methods: 10 patients with high-grade gliomas underwent CT, MRI, and 18F-FDOPA PET/CT images for post-operative radiation therapy planning. Two volumetric modulated arc therapy plans were retrospectively generated for each patient: a conventional plan with 60 Gy in 30 fractions to the planning target volume delineated on MRI and a dose-escalated plan with a maximum dose of 80 Gy in 30 fractions to BTVs. BTVs were created by thresholding 18F-FDOPA PET/CT uptake using a linear quadratic model that assumed tracer uptake was linearly related to tumour cell density. The maximum doses and equivalent uniform doses of OARs were compared. Results: The median volume of the planning target volume receiving at least 95% of the prescribed dose (V 95%) was 99.6% with and 99.5% without dose painting. The median V 95% was >99.2% for BTVs. The maximum doses and equivalent uniform doses to the OARs did not differ significantly between the conventional and dose-painted plans. Conclusion: Using commercially available treatment planning software, dose painting for high-grade gliomas was feasible with good BTV coverage and no significant change in the dose to OARs. Advances in knowledge: A novel treatment planning strategy was used to achieve dose painting for gliomas with BTVs obtained from 18F-FDOPA PET/CT using a radiobiological model.

scholarly journals Targeting Stereotactic Body Radiotherapy on Metabolic PET- and Immuno-PET-Positive Vertebral Metastases

Biomedicines ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. 548
Author(s):  
Baptiste Pichon ◽  
Caroline Rousseau ◽  
Audrey Blanc-Lapierre ◽  
Gregory Delpon ◽  
Ludovic Ferrer ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Stereotactic Body Radiotherapy ◽  
Metastatic Breast ◽  
Target Volume ◽  
Emission Tomography ◽  
Vertebral Metastases ◽  
Positron Emission ◽  
Pet Ct ◽  
Target Volumes ◽  
The Impact

(1) Background: Stereotactic body radiotherapy (SBRT) for vertebral metastases (VM) allows the delivery of high radiation doses to tumors while sparing the spinal cord. We report a new approach to clinical target volume (CTV) delineation based on anti-carcinoembryonic antigen (CEA) positron emission tomography (pretargeted immuno-PET; “iPET”) in patients with metastatic breast cancer (BC) or medullary thyroid cancer (MTC). (2) Methods: All patients underwent iPET, spine magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) using 18F-deoxyglucose (FDG) for BC or 18F-dihydroxy-phenylalanine (F-DOPA) for MTC. Vertebrae locations and vertebral segments of lesions were recorded and the impact on CTV delineation was evaluated. (3) Results: Forty-six VM eligible for SBRT following iPET were evaluated in eight patients (five BC, three MTC). Eighty-one vertebral segments were detected using MRI, 26 with FDG or F-DOPA PET/CT, and 70 using iPET. iPET was able to detect more lesions than MRI for vertebral bodies (44 vs. 34). iPET-based delineation modified MRI-based CTV in 70% (32/46) of cases. (4) Conclusion: iPET allows a precise mapping of affected VM segments, and adds complementary information to MRI in the definition of candidate volumes for VM SBRT. iPET may facilitate determining target volumes for treatment with stereotactic body radiotherapy in metastatic vertebral disease.

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