[18F]FDG-Positron Emission Tomography Coregistration With Computed Tomography Scans for Radiation Treatment Planning of Lymphoma and Hematologic Malignancies

Terezakis, Stephanie A.; Hunt, Margie; Kowalski, Alexander; McCann, Paul; Schmidtlein, C. Ross; Reiner, Anne S.; Gönen, Mithat; Kirov, A; Gonzales, Anne Marie; Schöder, Heiko; Yahalom, Joachim

doi:10.1016/j.ijrobp.2010.06.044

Cited by 36 publications

(20 citation statements)

References 24 publications

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“…However, serendipitously, radiologists using the radiotracer 18 F-fluorodeoxyglucose ( 18 F-FDG) in positron-emission tomography and computed tomography (PET/CT) to detect metabolically active tumours [10,11] found competing areas with high rates of glucose uptake that were symmetrical in nature [12] . These areas were most commonly localized in the supraclavicular and neck regions [13][14][15] .…”

Section: White Brown and Brite Adipose Tissuementioning

confidence: 99%

Role of Exercise in the Activation of Brown Adipose Tissue

Sánchez-Delgado¹,

Martínez-Téllez²,

Olza³

et al. 2015

Ann Nutr Metab

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Background: The energy-burning capacity of brown adipose tissue (BAT) makes it an attractive target for use in anti-obesity therapies. Moreover, due to its ability to oxidize glucose and lipids, BAT activation has been considered a potential therapy to combat type 2 diabetes and atherogenesis. Summary: BAT is mainly regulated by the sympathetic nervous system (SNS); yet, recent findings have shown a group of novel activators that act independently of the stimulation of the SNS such as cardiac natriuretic peptides, irisin, interleukin-6, β-aminoisobutyric acid and fibroblast growth factor 21 that could influence BAT metabolism. Several strategies are being examined to activate and recruit BAT with no side effects. In this review, we postulate that exercise might activate and recruit human BAT through the activation of SNS, heart and skeletal muscle. Key Messages: Epidemiological and well-designed exercise-based randomized controlled studies are needed to clarify if exercise is able to activate BAT in humans.

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Section: White Brown and Brite Adipose Tissuementioning

confidence: 99%

Role of Exercise in the Activation of Brown Adipose Tissue

Sánchez-Delgado¹,

Martínez-Téllez²,

Olza³

et al. 2015

Ann Nutr Metab

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“…We previously performed a retrospective study analyzing the volume changes that occur when PET is incorporated into CT for radiotherapy planning of HL and NHL (2). However, this prior pilot study was limited in patient numbers and did not utilize a standardized PET technique.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study of 18FDG-PET With CT Coregistration for Radiation Treatment Planning of Lymphomas and Other Hematologic Malignancies

Terezakis¹,

Schöder²,

Kowalski³

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Purpose This prospective single-institution study examines the impact of positron emission-tomography (PET) using 2-[18F] fluoro-2-deoxyglucose and CT scan radiation treatment planning (TP) on target volume definition in lymphoma. Methods and Materials 118 patients underwent PET/CT TP during 6/2007-5/2009. Gross tumor volume (GTV) was contoured on CT-only and PET/CT studies by radiation oncology (RO) and nuclear medicine (NM) for 95 patients with positive PET scans. Treatment plans and dose-volume histograms were generated for CT-only and PET/CT for 95 evaluable sites. Paired t-test statistics and Pearson correlation coefficients were used for analysis. Results 70 (74%) patients had non-Hodgkin lymphoma, 10 (11%) had Hodgkin lymphoma, 12 (10%) plasma-cell neoplasm, and 3 (3%) other hematologic malignancies. Forty-three (45%) presented with relapsed/refractory disease. Forty-five (47%) received no prior chemotherapy. The addition of PET increased GTV as defined by RO in 38 patients (median, 27%; range, 5-70%) and decreased GTV in 41 (median, 39.5%; range, 5-80%). The addition of PET increased GTV as defined by NM in 27 patients (median, 26.5%; range, 5-95%) and decreased GTV in 52 (median, 70%; range, 5-99%). Intra-observer correlation between CT-GTV and PET-GTV was higher for RO than for NM (0.94, P < .01 vs. 0.89, P < .01). Based on Bland-Altman plots, the PET-GTVs defined by RO were larger than NM. On evaluating clinical TPs, only four (4%) patients had inadequate target coverage (D95<95%) of the PET-GTV defined by NM. Conclusions Significant differences between RO and NM volumes were identified when PET was co-registered to CT for radiation planning. Despite this, the PET-GTV defined by RO and NM received acceptable prescription dose in nearly all patients. However, given the potential for a marginal miss, consultation with an experienced PET reader is highly encouraged when delineating PET/CT volumes, particularly for questionable lesions and to assure complete and accurate target volume coverage.

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“…1,9 In addition, multiple retrospective studies have shown that the incorporation of PET into treatment planning for lymphoma leads to significant alterations in treatment volume. [10][11][12] As a result, the inclusion of PET/CT in treatment planning is now standard practice; FDG-PET is mandatory for INRT and ideal for the application of ISRT. 12 As previously mentioned, there are many challenges in interpreting PET data.…”

Section: Discussionmentioning

confidence: 99%