PET/CT in radiation oncology

Fonti, Rosa; Conson, Manuel; Vecchio, Silvana Del

doi:10.1053/j.seminoncol.2019.07.001

Cited by 75 publications

(68 citation statements)

References 94 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are two directions for using predictive biomarkers for individualized treatment, to choose the treatment offered to a patient (e.g., intensifying and choosing a multimodal therapy for a hypoxic tumor with radiation and chemotherapy resistance factors or de-escalating treatment for tumors with radiosensitivity-associated factors such as HPV viral etiology for head and neck cancers). The modulation of the treatment by altered therapeutic and fractional associations (hypo-and hyperfractionation) aims to obtain a higher TCP with the limitation of NTCP of the tissues from the vicinity of target volumes, avoiding the risk of toxicity [2,24,26,27].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implications of Radiosensitizer and Radioprotector Factors in Refining the Dose-Volume Constraints and Radiobiological Models

Mireștean¹,

Buzea²,

Iancu³

et al. 2021

Translational Research in Cancer

View full text Add to dashboard Cite

Radiotherapy is a cornerstone of the modern treatment of many types of cancer, having both curative and palliative roles. It is estimated that more than half of cancer patients will need radiation therapy in the course of evolution. The goal of radiotherapy is to maximize tumor control, reducing adverse effects on normal tissues in close proximity at the same time. Improving the therapeutic ratio is the main goal of the efforts made to improve the technique and accuracy of the radiotherapy by using the targeting of the tumor volume with the help of the imaging guide and the dose conformation around the target volume. The use of the multi-leaf collimator (MLC) allowed a better coverage of the target volume in the irradiation field, thus reducing the unnecessary irradiation of healthy tissues. The use of radioprotective agents and radiosensitizers is another strategy to maximize the effect of radiotherapy. Recently, interest has focused on the design of irradiation protocols that exploit the differences in biology in terms of the response to irradiation between tumor cells and normal tissues.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Adaptive risk optimization uses a biological objective function instead of an objective function based on dose-volume constraints, maximizing TCP for different regions of the tumor with recurrent risk while also minimizing NTCP for risk organs [2,26,35].…”

Section: Introductionmentioning

confidence: 99%

Implications of Radiosensitizer and Radioprotector Factors in Refining the Dose-Volume Constraints and Radiobiological Models

Mireștean¹,

Buzea²,

Iancu³

et al. 2021

Translational Research in Cancer

View full text Add to dashboard Cite

show abstract

“…Integration of functional positron emission tomography (PET) images and anatomical computed tomography (CT) images provides the most comprehensive tool for oncological imaging 1,2 due to significant advantages in the detection and characterization of various lesions and in staging cancer and metastatic disease. 1,[3][4][5] Consequently, the volume of radiotracer imaging with the labeled glucose analog fluorodeoxyglucose F-18 (FDG) reached new heights in 2019, with an estimate of over 1.8 million scans and an annual growth rate of about 6% since 2013 in the U.S. alone. 6 Positron emission tomography/CT enables accurately coregistered dual-modality images that provide improved anatomical localization of tracer uptake, 7 which lead to a significant shift in the ratio of CT-coupled to noncoupled PET imaging systems, 6 from 2% in 2001 to 96% in 2018.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantitative positron emission tomography imaging in the presence of iodinated contrast media using electron density quantifications from dual‐energy computed tomography

et al. 2020

View full text Add to dashboard Cite

Purpose As preparation for future positron emission tomography (PET)/dual‐energy computed tomography (DECT)T imaging modality and new possible clinical applications, the study aimed to evaluate the utility of clinically available spectral results from a DECT system for improving attenuation corrections of PET acquisitions in the presence of iodinated contrast media. The dependence of the accuracy of PET quantification values, reconstructed with conventional and spectral‐based attenuation corrections, was examined as a function of the amount of iodine content and x‐ray radiation exposure. Methods Measurements were performed on commercial PET/CT and DECT systems, using a semi‐anthropomorphic phantom with seven centrifuge tubes in its bore. Five different configurations of tube contents were scanned by both PET/CT and DECT. With the aim of mimicking clinically observed concentrations, in all phantom configurations the center tube contained a high concentration of radionuclide while the peripheral tubes contained a lower concentration of radionuclide. Iodine content was incrementally increased between phantom configurations by replacing iodine‐free tubes with tubes that contained the original radionuclide concentration within a 10 mg/ml iodine dilution. DECT‐based attenuation correction maps were generated by scaling electron density spectral results into corresponding 511 keV photon linear attenuation coefficients. Results Mean SUV values obtained from the nominal PET reconstruction, using conventional CT images as input for the attenuation correction, demonstrate a monotonic increase of 8.6% when the water and radionuclide mixtures were replaced by iodine, water, and radionuclide (same level of activity) mixture. Mean SUV values obtained from the DECT‐based reconstruction, in which the attenuation correction utilizes electron density values as input, demonstrate different, more stable behavior across all iodine insert configurations, with a standard deviation to mean ratio of less than 1%. This observed behavior was independent of the area size used for measurement. A minor radiation dose dependency of the electron density values (below 0.5%) was observed. This resulted in consistent (iodine independent) PET quantification behavior, which persisted even at the lowest radiation dose levels tested in our experiment, that is, 25% of the radiation dose utilized for CT acquisition in the clinical PET/CT protocol. Conclusions Utilization of DECT‐generated electron density estimations for attenuation correction benefit PET quantification consistency in the presence of iodine and at nominal and low DECT radiation exposure levels. The ability to correctly account for iodinated contrast media in PET acquisitions will allow the development of new clinical applications that rely on the quantitative capabilities of spectral CT technologies and modern PET systems.

show abstract

“…7 Fluorine-18 labeled deoxyglucose ( 18 FDG) imaging has been the backbone of molecular imaging and is in extensive clinical use for diagnosing and staging of solid cancers and in evaluating response to therapy in patients with various malignancies. 8 18 FDG imaging has also provided an interesting insight into the tumor microenvironment: a highly hypoxic and acidic milieu, primarily dependent upon anerobic glycolysis for meeting its energy demand. This requires a profound increase in glucose uptake, facilitated by an upregulation of cell membrane GLUT transporters and an upgraded system for clearance of lactic acid and other waste metabolites in the cancer cells.…”

mentioning

confidence: 99%

Molecular imaging of tumor-specific markers and their expression in other organs

Jain

2021

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

PET/CT in radiation oncology

Cited by 75 publications

References 94 publications

Implications of Radiosensitizer and Radioprotector Factors in Refining the Dose-Volume Constraints and Radiobiological Models

Implications of Radiosensitizer and Radioprotector Factors in Refining the Dose-Volume Constraints and Radiobiological Models

Quantitative positron emission tomography imaging in the presence of iodinated contrast media using electron density quantifications from dual‐energy computed tomography

Molecular imaging of tumor-specific markers and their expression in other organs

Contact Info

Product

Resources

About