The utility of positron emission tomography/computed tomography in target delineation for stereotactic body radiotherapy for liver metastasis from primary gastric cancer: an illustrative case report and literature review

Abstract

Abstract:The liver is a common site for metastatic disease for many cancers. Radiation therapy is one means of treatment for liver metastases, especially for patients unable to undergo surgery or ineligible for systemic chemotherapy. In particular, stereotactic body radiotherapy (SBRT) has become an important option in the treatment of metastatic disease in the liver. SBRT delivers ablative doses of radiation in relatively few fractions. As such, precise and clear imaging plays an important role in maximizing disease control while minimizing normal tissue toxicity. We present a case that highlights the importance of using multiple imaging modalities for target volume delineation in stereotactic radiation treatment of liver metastases.

Multimodality Treatment in Metastatic Gastric Cancer: From Past to Next Future

“…Besides resection, other locoregional treatments such as radiofrequency ablation (RFA), microwave ablation (MWA) [ 16 ], hepatic artery infusion chemotherapy (HAIC) [ 17 ], transarterial chemoembolization (TACE) [ 18 ], and stereotactic body radiotherapy (SBRT) [ 19 ] have been investigated in mGC. Overall, these treatments were less invasive and associated with less minor and major complications, resulting at least non-inferior if compared to resection in highly-selected mGC patients with small (e.g., <3–5 cm in size for RFA and MWA) liver-limited lesions [ 16 ].…”

“…On the other hand, if surgery represents the cornerstone in the curative setting, its role in the metastatic disease is associated with controversial results [ 11 , 12 , 13 , 14 ] as well as the impact of other locoregional strategies [ 15 , 16 , 17 , 18 , 19 ]. In this regard, the concept of “oligometastatic” GC, stating a disease characterized by limited tumor burden (i.e., M1 with retroperitoneal lymph nodes and/or one potentially resectable incurable site), is taking place as emerging clinical entity, distinct from extensively mGC (M1 patients other than oligometastatic) in terms of both treatment plan (multimodal treatment vs. systemic treatment alone, respectively) and survival (mOS of about 31 months vs. 9–11 months, respectively) [ 12 , 13 , 14 , 15 , 20 ].…”

Surgical management of metastatic gastric cancer: moving beyond the guidelines

“…Because liver metastases are frequently encountered, several studies have focused on treating liver metastasis in light of the favorable outcomes of liver-directed treatment (LDT) options in the management of liver metastasis from colorectal and neuroendocrine cancer. Among LDT options, although liver resection is the most well-studied, radiofrequency ablation (RFA), microwave ablation (MWA), hepatic artery infusion chemotherapy (HAIC), transarterial chemoembolization (TACE), and stereotactic body radiotherapy (SBRT) have been used to treat liver metastasis from gastric cancer (LMGC) (25)(26)(27)(28)(29)(30)(31)(32)(33)(34).…”

Medical imaging modalities using nanoprobes for cancer diagnosis: A literature review on recent findings

“…The main disadvantage of PET is the lack of anatomical information, and this has recently been compensated by merging these devices with either CT or MRI known as dual modalities imaging named PET/CT and PET/MRI. [11]…”