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Radiation Oncology
Published in: Radiation Oncology 1/2009

Open Access 01-12-2009 | Research

[68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning

Authors: Barbara Gehler, Frank Paulsen, Mehmet Ö Öksüz, Till-Karsten Hauser, Susanne M Eschmann, Roland Bares, Christina Pfannenberg, Michael Bamberg, Peter Bartenstein, Claus Belka, Ute Ganswindt

Published in: Radiation Oncology | Issue 1/2009

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Abstract

Purpose

The observation that human meningioma cells strongly express somatostatin receptor (SSTR 2) was the rationale to analyze retrospectively in how far DOTATOC PET/CT is helpful to improve target volume delineation for intensity modulated radiotherapy (IMRT).

Patients and Methods

In 26 consecutive patients with preferentially skull base meningioma, diagnostic magnetic resonance imaging (MRI) and planning-computed tomography (CT) was complemented with data from [68Ga]-DOTA-D Phe1-Tyr3-Octreotide (DOTATOC)-PET/CT. Image fusion of PET/CT, diagnostic computed tomography, MRI and radiotherapy planning CT as well as target volume delineation was performed with OTP-Masterplan®. Initial gross tumor volume (GTV) definition was based on MRI data only and was secondarily complemented with DOTATOC-PET information. Irradiation was performed as EUD based IMRT, using the Hyperion Software package.

Results

The integration of the DOTATOC data led to additional information concerning tumor extension in 17 of 26 patients (65%). There were major changes of the clinical target volume (CTV) which modify the PTV in 14 patients, minor changes were realized in 3 patients. Overall the GTV-MRI/CT was larger than the GTV-PET in 10 patients (38%), smaller in 13 patients (50%) and almost the same in 3 patients (12%). Most of the adaptations were performed in close vicinity to bony skull base structures or after complex surgery. Median GTV based on MRI was 18.1 cc, based on PET 25.3 cc and subsequently the CTV was 37.4 cc. Radiation planning and treatment of the DOTATOC-adapted volumes was feasible.

Conclusion

DOTATOC-PET/CT information may strongly complement patho-anatomical data from MRI and CT in cases with complex meningioma and is thus helpful for improved target volume delineation especially for skull base manifestations and recurrent disease after surgery.
Appendix
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Metadata
Title
[68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning
Authors
Barbara Gehler
Frank Paulsen
Mehmet Ö Öksüz
Till-Karsten Hauser
Susanne M Eschmann
Roland Bares
Christina Pfannenberg
Michael Bamberg
Peter Bartenstein
Claus Belka
Ute Ganswindt
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2009
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-4-56

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