PO-115: A [18F] FDG-PET adaptive thresholding algorithm delineation of RT tumour volumes of head and neck cancer

Deantonio, Letizia; Paolini, Michael A.; Vigna, L.; Loi, G.; Masini, Laura; Sacchetti, Gianmauro; Matheoud, Roberta; Brambilla, Marta; Krengli, Marco

doi:10.1016/s0167-8140(17)30249-9

Cited by 2 publications

(4 citation statements)

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“…Only primary tumor and local recurrence was considered for MTV contouring, and neck nodes were included only when positive at PET pre . In this regard, ATA contouring method was previously developed and validated on pre-clinical data by Brambilla et al [ 8 , 12 ]. ATA is a standardized image segmentation tool using an objective function that generates a threshold based upon the characteristics of each tumor lesion and the tumor to background signal ratio thus the pixels are labelled as target (MTV) if their intensity is higher than the threshold, whereas those with a lower intensity are considered non-target).…”

Section: Methodsmentioning

confidence: 99%

“…According to the current literature, only few studies describe RT failure in terms of localization and biological features. Chao et al observed that almost 50% of failures after definitive RT were infield and occurred within the 95% isodose coverage region, despite an adequate target definition and coverage [ 5 ].In addition to CT and MRI, [ 18 F] FDG-PET/CT can be used to assess metabolic tumor function and anatomic localization for staging, RT planning, and restaging during follow-up in HNC [ 6 – 8 ]. Some authors found that the majority of HNC failures map to the pre-treatment PET abnormality [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Correlation of [18F] FDG-PET/CT with dosimetry data: recurrence pattern after radiotherapy for head and neck carcinoma

et al. 2021

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Objective To analyze the pattern of failure in relation to pre-treatment [18F] FDG-PET/CT uptake in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive radio-chemotherapy (RT-CHT). Methods and materials From 2012 to 2016, 87 HNSCC patients treated with definitive RT-CHT, with intensity modulated radiation therapy with simultaneous integrated boost, underwent pre-treatment [18F] FDG-PET/CT (PETpre), and MRI/CT for radiotherapy (RT) planning purposes. Patients with local recurrence, received [18F] FDG-PET/CT, (PETrec) at the time of the discovery of recurrence. In these patients, the metabolic target volume (MTV), MTVpre and MTVrec were segmented on PET images by means of an adaptive thresholding algorithm. The overlapping volume between MTVpre and MTVrec (MTVpre&rec) was generated and the dose coverage of MTVrec and MTVpre&rec was checked on the planning CT using the D99 and D95 dose metrics. The recurrent volume was defined as: ‘‘In-Field (IF)’’, “Marginal recurrence” or ‘‘Out-of-Field (OF)’’ if D95 was respectively equal or higher than 95%, D95 was between 95 and 20% or the D95 was less than 20% of prescribed dose. Results We found 10/87 patients (11.5%) who had recurrence at primary site. Mean MTVpre was 12.2 cc (4.6–28.9 cc), while the mean MTVrec was 4.3 cc (1.1–12.7 cc). Two recurrences resulted 100% inside MTVpre, 4 recurrences were mostly inside (61–91%) and 4 recurrences were marginal to MTVpre (1–33%). At dosimetric analysis, five recurrences (50%) were IF, 4 (40%) marginal and one (10%) OF. The mean D99 of the overlapping volumes MTVpre&rec was 68.1 Gy (66.5–69.2 Gy), considering a prescription dose of 70 Gy to the planning target volume (PTV). Conclusion Our study shows that the recurrence may originate from the volume with the highest FDG-signal. Tumor relapse in the high-dose volume support the hypothesis that an intensification of the dose on these volumes could be further assessed to prevent local relapse.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correlation of [18F] FDG-PET/CT with dosimetry data: recurrence pattern after radiotherapy for head and neck carcinoma

et al. 2021

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“…Only primary tumor and local recurrence was considered for BTV contouring, and neck nodes were included only when conglomerated with the primary tumor. In this regard, ATA contouring method was previously developed and validated on pre-clinical data by Brambilla et al 8,12 . ATA is a standardized image segmentation tool using an objective function that generates a threshold based upon the characteristics of each tumor lesion and the tumor to background signal ratio thus the pixels are labelled as target (BTV) if their intensity is higher than the threshold, whereas those with a lower intensity are considered non-target).…”

Section: Imaging Acquisition and Btv De Nition At Recurrencementioning

confidence: 99%

“…According to the current literature, only few studies describe RT failure in terms of localization and biological features. Chao et al observed that almost 50% of failures after de nitive RT were in eld and occurred within the 95% isodose coverage region, despite an adequate target de nition and coverage 5 .In addition to CT and MRI, [ 18 F] FDG-PET/CT can be used to assess metabolic tumor function and anatomic localization for staging, RT planning, and restaging during follow-up in HNC [6][7][8] . Some authors found that the majority of HNC failures map to the pre-treatment PET abnormality [9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Correlation of [18F] FDG-PET/CT with dosimetry data: recurrence pattern after radiotherapy for head and neck carcinoma

Pisani

Vigna

Mastroleo

et al. 2020

Preprint

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ObjectiveTo analyze the pattern of failure in relation to pre-treatment [18F] FDG-PET/CT uptake in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive radio-chemotherapy (RT-CHT).Methods and MaterialsFrom 2012 to 2016, 87 HNSCC patients treated with definitive RT-CHT, with intensity modulated radiation therapy with simultaneous integrated boost (IMRT-SIB), underwent pre-treatment [18F] FDG-PET/CT (PETpre), and MRI/CT for radiotherapy (RT) planning purposes. Patients with local recurrence, received [18F] FDG-PET/CT, (PETrec) at the time of the discovery of recurrence. In these patients, the biological target volume (BTV), BTVpre and BTVrec were segmented on PET images by means of an adaptive thresholding algorithm. The overlapping volume between BTVpre and BTVrec (BTVpre&rec) was generated and the dose coverage of BTVrec and BTVpre&rec was checked on the planning CT using the D99 and D95 dose metrics. The recurrent volume was defined as: ‘‘In-Field (IF)’’, ‘‘Extending Outside the Field (EOF)’’ or ‘‘Out-of-Field (OF)’’ if D95 was respectively equal or higher than 95%, D95 was between 95% and 20% or the D95 was less than 20% of prescribed dose.ResultsWe found 10/87 patients (11.5%) who had recurrence at primary site. Mean BTVpre was 13.1 cc (4.6-37.4 cc), while the mean BTVrec was 4.3 cc (1.1-12.7 cc). Two recurrences resulted 100% inside BTVpre, 4 recurrences were mostly inside (61%-91%) and 4 recurrences were marginal to BTVpre (33-1%). At dosimetric analysis, six recurrences (60%) were IF, 3 (30%) EOF and one (10%) OF. The mean D99 of the overlapping volumes BTVpre&rec was 68.1Gy (66.5-69.2 Gy), considering a prescription dose of 70 Gy to the planning target volume (PTV). ConclusionOur study shows that the recurrence may originate from the volume with the highest FDG-signal. Results support the hypothesis that an intensification of the dose on these volumes could be helpful to prevent local relapse.

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PO-115: A [18F] FDG-PET adaptive thresholding algorithm delineation of RT tumour volumes of head and neck cancer

Cited by 2 publications

References 0 publications

Correlation of [18F] FDG-PET/CT with dosimetry data: recurrence pattern after radiotherapy for head and neck carcinoma

Correlation of [18F] FDG-PET/CT with dosimetry data: recurrence pattern after radiotherapy for head and neck carcinoma

Correlation of [18F] FDG-PET/CT with dosimetry data: recurrence pattern after radiotherapy for head and neck carcinoma

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