Dosimetric impact of amino acid positron emission tomography imaging for target delineation in radiation treatment planning for high-grade gliomas

Kazda, Tomáš; Pafundi, Deanna H.; Kraling, Alan; Bradley, Thomas B.; Lowe, Val J.; Brinkmann, Debra H.; Laack, Nadia N.

doi:10.1016/j.phro.2018.06.004

Cited by 6 publications

(32 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dowson et al concluded that volumes defined by 18F-FDOPA PET resulted in larger GTV as well than T1-CE MRI-based GTV. Therefore, MRI and 18F-FDOPA PET-based treatment planning appeared feasible in patients with high-grade gliomas (42,43).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Additional Value of 18F-FDOPA Amino Acid Analog Radiotracer to Irradiation Planning Process of Patients With Glioblastoma Multiforme

Sipos

László²,

Tóth

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

PurposeTo investigate the added value of 6-(18F]-fluoro-L-3,4-dihydroxyphenylalanine (FDOPA) PET to radiotherapy planning in glioblastoma multiforme (GBM).MethodsFrom September 2017 to December 2020, 17 patients with GBM received external beam radiotherapy up to 60 Gy with concurrent and adjuvant temozolamide. Target volume delineations followed the European guideline with a 2-cm safety margin clinical target volume (CTV) around the contrast-enhanced lesion+resection cavity on MRI gross tumor volume (GTV). All patients had FDOPA hybrid PET/MRI followed by PET/CT before radiotherapy planning. PET segmentation followed international recommendation: T/N 1.7 (BTV1.7) and T/N 2 (BTV2.0) SUV thresholds were used for biological target volume (BTV) delineation. For GTV-BTVs agreements, 95% of the Hausdorff distance (HD95%) from GTV to the BTVs were calculated, additionally, BTV portions outside of the GTV and coverage by the 95% isodose contours were also determined. In case of recurrence, the latest MR images were co-registered to planning CT to evaluate its location relative to BTVs and 95% isodose contours.ResultsAverage (range) GTV, BTV1.7, and BTV2.0 were 46.58 (6–182.5), 68.68 (9.6–204.1), 42.89 (3.8–147.6) cm3, respectively. HD95% from GTV were 15.5 mm (7.9–30.7 mm) and 10.5 mm (4.3–21.4 mm) for BTV1.7 and BTV2.0, respectively. Based on volumetric assessment, 58.8% (28–100%) of BTV1.7 and 45.7% of BTV2.0 (14-100%) were outside of the standard GTV, still all BTVs were encompassed by the 95% dose. All recurrences were confirmed by follow-up imaging, all occurred within PTV, with an additional outfield recurrence in a single case, which was not DOPA-positive at the beginning of treatment. Good correlation was found between the mean and median values of PET/CT and PET/MRI segmented volumes relative to corresponding brain-accumulated enhancement (r = 0.75; r = 0.72).Conclusion18FFDOPA PET resulted in substantial larger tumor volumes compared to MRI; however, its added value is unclear as vast majority of recurrences occurred within the prescribed dose level. Use of PET/CT signals proved to be feasible in the absence of direct segmentation possibilities of PET/MR in TPS. The added value of 18FFDOPA may be better exploited in the context of integrated dose escalation.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Results: Average (range) GTV, BTV1.7, and BTV2.0 were 46.58 (6-182.5), 68.68 (9.6-204.1), 42.89 (3.8-147.6) cm 3 , respectively. HD95% from GTV were 15.5 mm (7.9-30.7 mm) and 10.5 mm (4.3-21.4 mm) for BTV1.7 and BTV2.0, respectively.…”

mentioning

confidence: 99%

Additional Value of 18F-FDOPA Amino Acid Analog Radiotracer to Irradiation Planning Process of Patients With Glioblastoma Multiforme

Sipos

László²,

Tóth

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Interestingly, after inclusion of 18 F-FDOPA PET biologic imaging, the average 60-Gy isodose volumes for the five patients with contrast enhancement increased 1.3-fold and decreased 2.5-fold in the three patients without contrast enhancement. All priority dose volume constraints for PTV 60Gy (V 100% ≥ 95% and V 110% < 0.5 cc) were met in both treatment plans for all patients, and all plans met critical organs at risk constraints (according to the Radiation Therapy Oncology Group) [40]. In the two preceding studies listed, the authors reported problems with the PET volume delineation.…”

Section: Target Volume Delineation and Radiation Treatment Monitoringmentioning

confidence: 94%

Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature

et al. 2020

View full text Add to dashboard Cite

Contrast-enhanced magnetic resonance imaging is currently the standard of care in the management of primary brain tumors, although certain limitations remain. Metabolic imaging has proven useful for an increasing number of indications in oncology over the past few years, most particularly 18F-FDG PET/CT. In neuro-oncology, 18F-FDG was insufficient to clearly evaluate brain tumors. Amino-acid radiotracers such as 18F-FDOPA were then evaluated in the management of brain diseases, notably tumoral diseases. Even though European guidelines on the use of amino-acid PET in gliomas have been published, it is crucial that future studies standardize acquisition and interpretation parameters. The aim of this article was to systematically review the potential effect of this metabolic imaging technique in numerous steps of the disease: primary and recurrence diagnosis, grading, local and systemic treatment assessment, and prognosis. A total of 41 articles were included and analyzed in this review. It appears that 18F-FDOPA PET holds promise as an effective additional tool in the management of gliomas. More consistent prospective studies are still needed.

show abstract

“…The current RT techniques and procedures are completely different compared to those used in patients enrolled in the landmark Stupp's glioblastoma trial, the current standard of care 18,19 . Nowadays, more advanced RT techniques are available including the investigation of target definitions based on positron emission tomography imaging 20,21 . In this present study, the more accurate radiologists' estimation was for 80% isodose (the averaged volume was 79% of the original volume of this isodose region) comparing to the estimation of PTV volume (only 31% of the original PTV volume).…”

Section: Discussionmentioning

confidence: 99%

In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region

Belanová¹,

Šprláková-Puková²,

Standara³

et al. 2020

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

Self Cite

View full text Add to dashboard Cite

Background and Aim. Oncologists play a vital role in the interpretation of radiographic results in glioblastoma patients. Molecular pathology and information on radiation treatment protocols among others are all important for accurate interpretation of radiology images. One important issue that may arise in interpreting such images is the phenomenon of tumor "pseudoprogression"; oncologists need to be able to distinguish this effect from true disease progression. Exact knowledge about the location of high-dose radiotherapy region is needed for valid determination of pseudoprogression according to RANO (Response Assessment in Neuro-Oncology) criteria in neurooncology. The aim of the present study was to evaluate the radiologists' understanding of a radiotherapy high-dose region in routine clinical practice since radiation oncologists do not always report 3-dimensional isodoses when ordering follow up imaging. Methods. Eight glioblastoma patients who underwent postresection radiotherapy were included in this study. Four radiologists worked with their pre-radiotherapy planning MR, however, they were blinded to RT target volumes which were defined by radiation oncologists according to current guidelines. The aim was to draw target volume for high dose RT fields (that is the region, where they would consider that there may be a pseudoprogression in future MRI scans). Many different indices describing structure differences were analyzed in comparison with original per-protocol RT target volumes. Results. The median volume for RT high dose field was 277 ccm (range 218 to 401 ccm) as defined per protocol by radiation oncologist and 87 ccm (range 32-338) as defined by radiologists (median difference of paired difference 31%, range 15-112%). The Median Dice index of similarity was 0.46 (range 0.14-0.78), the median Hausdorff distance 25 mm. Conclusion. Continuing effort to improve education on specific procedures in RT and in radiology as well as automatic tools for exporting RT targets is needed in order to increase specificity and sensitivity in response evaluation.

show abstract

Dosimetric impact of amino acid positron emission tomography imaging for target delineation in radiation treatment planning for high-grade gliomas

Cited by 6 publications

References 18 publications

Additional Value of 18F-FDOPA Amino Acid Analog Radiotracer to Irradiation Planning Process of Patients With Glioblastoma Multiforme

Additional Value of 18F-FDOPA Amino Acid Analog Radiotracer to Irradiation Planning Process of Patients With Glioblastoma Multiforme

Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature

In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region

Contact Info

Product

Resources

About