• Int. J. Radiat. Oncol. Biol. Phys. · May 2010

    (18)F-FDG PET-CT simulation for non-small-cell lung cancer: effect in patients already staged by PET-CT.

    • Gerard G Hanna, Jonathan McAleese, Kathryn J Carson, David P Stewart, Vivian P Cosgrove, Ruth L Eakin, Ashraf Zatari, Tom Lynch, Peter H Jarritt, V A Linda Young, Joe M O'Sullivan, and Alan R Hounsell.
    • Centre for Cancer Research and Cell Biology, Queen's University of Belfast, Belfast, Northern Ireland, United Kingdom. Gerry.Hanna@googlemail.com
    • Int. J. Radiat. Oncol. Biol. Phys. 2010 May 1; 77 (1): 24-30.

    PurposePositron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition.Methods And MaterialsA total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test.ResultsPET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTV(CT) to GTV(FUSED) was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001).ConclusionPET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

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