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01-05-2008 | Clinical-Patient Studies

Simultaneous integrated boost technique by helical tomotherapy for the treatment of glioblastoma multiforme with ¹¹C-methionine PET: report of three cases

Authors: Kazuhiro Miwa, Masayuki Matsuo, Jun Shinoda, Naoki Oka, Takayuki Kato, Ayumi Okumura, Tatsuya Ueda, Kazutoshi Yokoyama, Jitsuhiro Yamada, Hirohito Yano, Shinichi Yoshimura, Toru Iwama

Published in: Journal of Neuro-Oncology | Issue 3/2008

Abstract

We performed hypofractionated high-dose irradiation of a patient’s residual glioblastoma multiforme using a simultaneous integrated boost (SIB) technique with helical tomotherapy system (HT) planning. The gross tumor volume (GTV)-1 was defined as the area of intensive ¹¹C-methionine (MET) uptake and GTV-2 was defined as the area of moderate MET uptake. The planning target volume (PTV)-1 encompassed GTV-1 plus a 5 mm margin, and PTV-2 encompassed GTV-2 plus a 2 mm margin. SIB with HT was performed in eight fractions, planning the dose for GTV-1 at 68 Gy (biologically effective dose: BED = 126 Gy), PTV-1 at 56 Gy (BED = 95 Gy), and PTV-2 at 40 Gy (BED = 60 Gy). In each of the target areas, the uptake value on ¹¹C-methionine positron emission tomography (MET-PET) was considerably decreased following SIB, although no remarkable changes were demonstrated on magnetic resonance imaging (MRI). These cases demonstrate that SIB with HT planning using MET-PET offers excellent target coverage and uniformity. In addition, SIB with HT planning using MET-PET is organ sparing and MET-PET has great efficacy for monitoring treatment response after SIB. To more clearly define the impact of SIB with HT planning using MET-PET, further investigations are required.

Floyd NS, Woo SY, Teh BS, Prado C, Mai WY, Trask T, Gildenberg PL, Holoye P, Augspurger ME, Carpenter LS, Lu HH, Chiu JK, Grant WH 3rd, Butler EB (2004) Hypofractionated intensity-modulated radiotherapy for primary glioblastoma multiforme. Int J Radiat Oncol Biol Phys 58:721–726PubMed

Narayana A, Yamada J, Berry S, Shah P, Hunt M, Gutin PH, Leibel SA (2006) Intensity-modulated radiotherapy in high-grade gliomas: clinical and dosimetric results. Int J Radiat Oncol Biol Phys 64:892–897PubMed

Welsh JS, Patel RR, Ritter MA, Harari PM, Mackie TR, Mehta MP (2002) Helical tomotherapy: an innovative technology and approach to radiation therapy. Technol Cancer Res Treat 1:311–316PubMed

Burger PC, Heinz ER, Shibata T, Kleihues P (1988) Topographic anatomy and CT correlations in the untreated glioblastoma multiforme. J Neurosurg 68:698–704PubMed

Goldman S, Levivier M, Pirotte B, Brucher JM, Wikler D, Damhaut P, Dethy S, Brotchi J, Hildebrand J (1997) Regional methionine and glucose uptake in high grade gliomas: a comparative study on PET-guided stereotactic biopsy. J Nucl Med 38:1459–1462PubMed

Kracht LW, Miletic H, Busch S, Jacobs AH, Voges J, Hoevels M, Klein JC, Herholz K, Heiss WD (2004) Delineation of brain tumor extent with [11C] L-methionine positron emission tomography: local comparison with stereotactic histopathology. Clin Cancer Res 1:7163–7170CrossRef

Pirotte B, Goldman S, Dewitte O, Massager N, Wikler D, Lefranc F, Ben Taib NO, Rorive S, David P, Brotchi J, Levivier M (2006) Integrated positron emission tomography and magnetic resonance imaging-guided resection of brain tumors: a report of 103 consecutive procedures. J Neurosurg 104:238–253PubMedCrossRef

Iuchi T, Hatano K, Narita Y, Kodama T, Yamaki T, Osato K (2006) Hypofractionated high-dose irradiation for the treatment of malignant astrocytomas using simultaneous integrated boost technique by IMRT. Int J Radiat Oncol Biol Phys 64:1317–1324PubMed

Ogawa T, Kanno I, Shishido F, Inugami A, Higano S, Fujita H, Murakami M, Uemura K, Yasui N, Mineura K et al (1991) Clinical value of PET with ¹⁸F-fluorodeoxyglucose and L-methyl-¹¹C methionine for diagnosis of recurrent brain tumor and radiation injury. Acta Radiol 32:197–202PubMedCrossRef

10.

De Witte O, Goldberg I, Wikler D, Rorive S, Damhaut P, Monclus M, Salmon I, Brotchi J, Goldman S (2001) Positron emission tomography with injection of methionine as a prognostic factor of glioma. J Neurosurg 95:746–750PubMed

11.

Nariai T, Tanaka Y, Wakimoto H, Aoyagi M, Tamaki M, Ishiwata K, Senda M, Ishii K, Hirakawa K, Ohno K (2005) Usefulness of L-[methyl-11C] methionine-positron emission tomography as a biological monitoring tool in the treatment of glioma. J Neurosurg 103:498–507PubMedCrossRef

12.

Ribom D, Eriksson A, Hartman M, Engler H, Nilsson A, Långström B, Bolander H, Bergström M, Smits A (2001) Positron emission tomography 11C-methionine and survival in patients with low-grade gliomas. Cancer 92:1541–1549PubMedCrossRef

13.

Grosu AL, Weber WA, Riedel E, Jeremic B, Nieder C, Franz M, Gumprecht H, Jaeger R, Schwaiger M, Molls M (2005) L-(methyl-11C) methionine positron emission tomography for target delineation in resected high-grade gliomas before radiotherapy. Int J Radiat Oncol Biol Phys 63:64–74PubMed

14.

Miwa K, Shinoda J, Yano H, Okumura A, Iwama T, Nakashima T, Sakai N (2004) Discrepancy between lesion distributions on methionine PET and MR images in patients with glioblastoma multiforme: insight from a PET and MR fusion image study. J Neurol Neurosurg Psychiatr 75:1457–1462PubMedCrossRef

15.

Grosu AL, Lachner R, Wiedenmann N, Stärk S, Thamm R, Kneschaurek P, Schwaiger M, Molls M, Weber WA (2003) Validation of a method for automatic image fusion (BrainLAB System) of CT data and 11C-methionine-PET data for stereotactic radiotherapy using a LINAC: first clinical experience. Int J Radiat Oncol Biol Phys 56:1450–1463PubMedCrossRef

16.

Levivier M, Massager N, Wikler D, Lorenzoni J, Ruiz S, Devriendt D, David P, Desmedt F, Simon S, Van Houtte P, Brotchi J, Goldman S (2004) Use of stereotactic PET images in dosimetry planning of radiosurgery for brain tumors: clinical experience and proposed classification. J Nucl Med 45:1146–1154PubMed

Title: Simultaneous integrated boost technique by helical tomotherapy for the treatment of glioblastoma multiforme with 11C-methionine PET: report of three cases
Authors: Kazuhiro Miwa
Masayuki Matsuo
Jun Shinoda
Naoki Oka
Takayuki Kato
Ayumi Okumura
Tatsuya Ueda
Kazutoshi Yokoyama
Jitsuhiro Yamada
Hirohito Yano
Shinichi Yoshimura
Toru Iwama
Publication date: 01-05-2008
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2008
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-008-9519-3

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Simultaneous integrated boost technique by helical tomotherapy for the treatment of glioblastoma multiforme with ¹¹C-methionine PET: report of three cases

Abstract

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Springer Medicine

Abstract

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