Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Abstract

Background and Purpose: To assess whether the pretreatment FDG-PET defined biologic target volume (PET-BTV) correlates with the anatomical sites of loco-regional failure (LRF) after RT for head & neck cancer (HNC).

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with18F-FDG PET,18F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

“…However, we did not find any correlation between the amount (size of the GTV FDG ) or the level (SUV max ) of 18 F-FDG uptake and disease-free survival, although this lack of correlation could be due to the limited number of patients. In fact, whereas the prognostic value of 18 F-FDG PET appears intuitively appealing, recent trials comparing SUV data to disease control in larger patient groups have reported conflicting results (27)(28)(29)(30). In any case, it appears prudent not to use 18 F-FDG PET as the sole instrument for delineating gross tumor volume, since locoregional failures can occur outside the GTV FDG (8,30).…”

“…In fact, whereas the prognostic value of 18 F-FDG PET appears intuitively appealing, recent trials comparing SUV data to disease control in larger patient groups have reported conflicting results (27)(28)(29)(30). In any case, it appears prudent not to use 18 F-FDG PET as the sole instrument for delineating gross tumor volume, since locoregional failures can occur outside the GTV FDG (8,30). Pathology studies have convincingly demonstrated that no single imaging modality can depict all tumor extensions (5).…”

18F-Fdg-PET-guided Planning and Re-Planning (Adaptive) Radiotherapy in Head and Neck Cancer: Current State of Art

“…Moreover, the delineation of GTV and standardized uptake value (SUV) levels evaluation allows the design of dose escalation strategies, improving the possibility to identify tumor subvolumes with higher risk of recurrences (17,(47)(48)(49)(50). 18 F-FDG PET may be useful even as a prognostic factor due to the ability to early detect tumor recurrences (15)(16)(17)(18)(51)(52)(53)(54).…”

“…RT has the aim to improve locoregional control both in early stage disease, where RT has an elective role, and in advanced stage, in the setting of combined modality treatment (5). It has been estimated that in the majority of cases, RT treated tumors relapse within the 95% dose coverage volume, probably due to the presence of radiation-resistant hypoxic areas (6)(7)(8)(9)(10)(11)(12).…”

Superiority of Deformable Image Co-registration in the Integration of Diagnostic Positron Emission Tomography-Computed Tomography to the Radiotherapy Treatment Planning Pathway for Oesophageal Carcinoma

“…This has previously been examined for head and neck patients [34]. Local recurrences were classified as 'infield', 'marginal' or 'out-of-field' if more than 95%, 20-94% and less than 20% of the recurrence volume was within the 95% isodose line [22].…”