Is there any impact of PET/CT on radiotherapy planning in rectal cancer patients undergoing preoperative IMRT?

Turk J Med Sci. 2015;45(1):129-35. doi: 10.3906/sag-1312-149.

Abstract

Background/aim: To investigate the effect of positron emission tomography-computed tomography (PET/CT)-based contouring on dosimetric parameters in rectal cancer patients undergoing preoperative intensity-modulated radiation therapy (IMRT).

Materials and methods: Preoperative radiation therapy plans with conformal radiotherapy (CRT) or IMRT were created and examined according to the CT- and PET/CT-based contouring of 20 rectal cancer patients, retrospectively.

Results: The target volumes delineated with PET/CT were significantlylarger than the volumes created by CT (P= 0.043). Dose delivered to 98% of the planning target volume was high in IMRT planning contouring with CT and PET/CT compared with CRT planning, but the difference was not statistically significant (P = 0.056). Percent volumes receiving 105% of dose and 110% of dose were low in IMRT planning when compared with CRT (P < 0.0001 and P = 0.044, respectively). The volumes receiving 45 Gy for the small intestine, femur heads, and bladder and the maximum dose received by the bladder were significantly lower in IMRT.

Conclusion: We showed that the target volumes created with PET/CT are significantly larger than the target volumes created with CT and that IMRT provides lower radiation exposure to the tumor-free tissues compared to the CRT planning. The dosimetric results primarily favor IMRT planning in rectal cancer patients and consequently present the significant alteration in target volumes.

MeSH terms

  • Femur Head / diagnostic imaging
  • Humans
  • Intestine, Small / diagnostic imaging
  • Multimodal Imaging / methods
  • Positron-Emission Tomography
  • Preoperative Care
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy, Intensity-Modulated / methods*
  • Rectal Neoplasms / diagnostic imaging*
  • Rectal Neoplasms / radiotherapy*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Urinary Bladder / diagnostic imaging