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Open Access 01-12-2014 | Research

Integrating respiratory-gated PET-based target volume delineation in liver SBRT planning, a pilot study

Authors: Olivier Riou, Benjamin Serrano, David Azria, Benoit Paulmier, Remy Villeneuve, Pascal Fenoglietto, Antonella Artenie, Cécile Ortholan, Marc Faraggi, Juliette Thariat

Published in: Radiation Oncology | Issue 1/2014

Abstract

Background

To assess the feasibility and benefit of integrating four-dimensional (4D) Positron Emission Tomography (PET) – computed tomography (CT) for liver stereotactic body radiation therapy (SBRT) planning.

Methods

8 patients with 14 metastases were accrued in the study. They all underwent a non-gated PET and a 4D PET centered on the liver. The same CT scan was used for attenuation correction, registration, and considered the planning CT for SBRT planning. Six PET phases were reconstructed for each 4D PET. By applying an individualized threshold to the 4D PET, a Biological Internal Target Volume (BITV) was generated for each lesion. A gated Planning Target Volume (PTVg) was created by adding 3 mm to account for set-up margins. This volume was compared to a manual Planning Target Volume (PTV) delineated with the help of a semi-automatic Biological Target Volume (BTV) obtained from the non-gated exam. A 5 mm radial and a 10 mm craniocaudal margins were applied to account for tumor motion and set-up margins to create the PTV.

Results

One undiagnosed liver metastasis was discovered thanks to the 4D PET. The semi-automatic BTV were significantly smaller than the BITV (p = 0.0031). However, after applying adapted margins, 4D PET allowed a statistically significant decrease in the PTVg as compared to the PTV (p = 0.0052).

Conclusions

In comparison to non-gated PET, 4D PET may better define the respiratory movements of liver targets and improve SBRT planning for liver metastases. Furthermore, non respiratory-gated PET exams can both misdiagnose liver metastases and underestimate the real internal target volumes.

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Title: Integrating respiratory-gated PET-based target volume delineation in liver SBRT planning, a pilot study
Authors: Olivier Riou
Benjamin Serrano
David Azria
Benoit Paulmier
Remy Villeneuve
Pascal Fenoglietto
Antonella Artenie
Cécile Ortholan
Marc Faraggi
Juliette Thariat
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2014
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-9-127

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Integrating respiratory-gated PET-based target volume delineation in liver SBRT planning, a pilot study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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