Challenges in integrating 18FDG PET-CT into radiotherapy planning of head and neck cancer.

Abstract:

:Radiotherapy forms one of the major treatment modalities for head and neck cancers (HNC), and precision radiotherapy techniques, such as intensity-modulated radiotherapy require accurate target delineation to ensure success of the treatment. Conventionally used imaging modalities, such as X-ray computed tomography (CT) and magnetic resonance imaging are used to delineate the tumor. Imaging, such as positron emission tomography (PET)-CT, which combines the functional and anatomic modalities, is increasingly being used in the management of HNC. Currently, 18-fluorodeoxyglucose is the most commonly used radioisotope, which is accumulated in areas of high glucose uptake, such as the tumor tissue. Because most disease recurrences are within the high-dose radiotherapy volume, defining a biological target volume for radiotherapy boost is an attractive approach to improve the results. There are many challenges in employing the PET-CT for radiotherapy planning, such as patient positioning, target edge definition, and use of new PET tracers, which represent various functional properties, such as hypoxia, protein synthesis, and proliferation. The role of PET-CT for radiotherapy planning is ever expanding and more clinical data underlining the advantages and challenges in this approach are emerging. In this article, we review the current clinical evidence for the application of functional imaging to radiotherapy planning and discuss some of the current challenges and possible solutions that have been suggested to date.

journal_name

Indian J Cancer

journal_title

Indian journal of cancer

authors

Dandekar P,Partridge M,Kazi R,Nutting C,Harrington K,Newbold K

doi

10.4103/0019-509X.64717

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

260-6

issue

3

eissn

0019-509X

issn

1998-4774

pii

IndianJournalofCancer_2010_47_3_260_64717

journal_volume

47

pub_type

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