Radiotherapy & Oncology
Volume 96, Issue 3 , Pages 339-346 , September 2010

Clinical evidence on PET-CT for radiation therapy planning in gastro-intestinal tumors

  • Maarten Lambrecht
  • ,
  • Karin Haustermans

      Affiliations

    • Corresponding Author InformationCorresponding author. Address: Department of Radiation Oncology, Leuvens Kankerinstituut, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.

Received 7 June 2010 ,Revised 26 July 2010 ,Accepted 27 July 2010.

References 

  1. Kapiteijn E, Marijnen AM, Nagtegaal ID, et al. Preoperative radiotherapy combined with Total mesorectal excision for resectable rectal cancer. N Engl J Med. 2001;345:638–646
  2. Mariette C, Piessen G, Triboulet JP. Therapeutic strategies in oesophageal carcinoma: role of surgery and other modalities. Lancet Oncol. 2007;8:545–553
  3. Berger B, Claus B. Evidence-based radiation oncology: Oesophagus. Radiother Oncol. 2009;92:276–290
  4. Valentini V, Cellini F, Minsk B, et al. Survival after radiotherapy in gastric cancer: Systematic review and meta-analysis. Radiother Oncol. 2009;92:176–183
  5. Sultana A, Tudur Smith C, Cunningham D, et al. Systematic review, including meta-analyses, on the management of locally advanced pancreatic cancer using radiation/combined modality therapy. Br J Cancer. 2007;96:1183–1190
  6. Bjerregaard J, Mortensen M, Jensen M, et al. Long-term results of concurrent radiotherapy and UFT in patients with locally advanced pancreatic cancer. Radiother Oncol. 2009;92:226–230
  7. Abdel-Nabi H, Doerr RJ, Lamonica DM, et al. Staging of primary colorectal carcinomas with fluorine-18 fluorodeoxuglucose whole body PET: Correlation with histopathologic and CT findings. Radiology. 1998;206:755–760
  8. Kantorova I, Lipska L, Belohlavek O, et al. Routine (18)F-FDG PET preoperative staging of colorectal cancer: Comparison with conventional staging and ist impact on treatment decision making. J Nucl Med. 2003;44:1784–1788
  9. Bipat S, van Leeuwen MS, Comans EF, et al. Colorectal liver metastases: CT, MR imaging and PET for diagnosis-meta-analysis. Radiology. 2005;224:748–756
  10. Huebner RH, Park KC, Shepherd JE, et al. A Meta-analysis of the literature for whole-body FDG PET detection of recurrent colorectal cancer. J Nucl Med. 2000;41:1177–1189
  11. Flanagan FL, Dehdashti F, Siegel BA, et al. Staging of esophageal cancer with 18F-fluorodeoxyglucose positron emission tomography. AJR Am J roentgenol. 1997;168:417–424
  12. Lerut T, Flamen P, Ectors N, et al. Histopathologic validation of lymph node staging with FDG-PET scan in cancer of the esophagus and gastroesophageal junction: A prospective study based on primary surgery with extensive lymphadenectomy. Ann Surg. 2000;232:743–752
  13. Flamen P, Lerut A, Van Cutsem E, et al. The utility of positron emission tomography for the diagnosis and staging of recurrent esophageal cancer. J Thorac Cardiovasc Surg. 2000;120:1085–1092
  14. Janssen MH, Ollers MC, Riedl RG, et al. Accurate prediction of pathological rectal tumor response after two weeks of preoperative radiochemotherapy using (18)F-fluorodeoxyglucose-positron emission tomography-computed tomography imaging. Int J Radiat Oncol Biol Phys. 2010;77:392–399
  15. Aerts HJ, Lambin P, De Ruysscher D. FDG for dose painting: a rational choice. Radiother Oncol. 2010;[Epub ahead of print]
  16. Been LB, Suurmeijer AJH, Cobben P, Jager P, Hoekstra HJ, Elsinga PH. [18F]FLT-PET in oncology: current status and and opportunities. Eur J Nuc Med Mol Imaging. 2004;31:1659–1672
  17. Koh WJ, Rasey JS, Evans ML, et al. Imaging of hypoxia in human tumors with 18F-fluoromisonidazole. Int J Radiat Oncol Biol Phys. 1992;41:31–39
  18. MacManus M, Nestle U, Rosenzweig KE, et al. Use of PET and PET/CT for radiation therapy planning: IAEA expert report 2006–2007. Radiother Oncol. 2009;91:85–94
  19. Siewert JR, Ott K. Are squamous and adenocarcinomas of the esophagus the same disease?. Semin Radiat Oncol. 2006;17:38–44
  20. Mamede M, El Fakhri G, Abrue-e Lima P, Gandler W, Nosé V, Gerbaudo VH. Preoperative estimation of esophageal tumor metabolic length in FDG-PET images with surgical pathology confirmation. Ann Nucl Med. 2007;21:553–562
  21. Zhong X, Yu J, Zhang B, et al. Using 18F-fluorodeoxyglucose positron emission tomography to estimate the length of gross tumor in patients with squamous cell carcinoma of the Esophagus. Int J Radiat Oncol Biol Phys. 2009;73:136–141
  22. Yu W, Fu XL, Zhang YJ, et al. GTV spatial conformity between different delineations methods by 18FDG-PET/CT and pathology in esophageal cancer. Radiother Oncol. 2009;93:441–446
  23. Daisne JF, Sibomana M, Bol A, et al. Tri-dimensional automatic segmentation of PET volumes based on measured source-to-background ratios: Influence of reconstruction algorithms. Radiother Oncol. 2003;69:247–250
  24. Roels S, Slagmolen P, Nuyts J, et al. Biological image-guided radiotherapy in rectal cancer: challenges and pitfalls. Int J Radiat Oncol Biol Phys. 2009;75:782–790
  25. Vrieze O, Haustermans K, De Wever W, et al. Is there a role for FGD-PET in radiotherapy planning in esophageal carcinoma?. Radiother Oncol. 2004;73:269–275
  26. Shimizu S, Hosokawa M, Itoh K, Fujita M, Takahashi H, Shirato H. Can hybrid FDG-PET/CT detect subclinical lymph node metastasis of esophageal cancer appropriately and contribute to radiation treatment planning? A comparison of image-based an pathological findings. Int J Clin Oncol. 2009;14:421–425
  27. Leong T, Everitt C, Yuen K, et al. A prospective study to evaluate the impact of FDG-PET on CT-based radiotherapy treatment planning for oesophageal cancer. Radiother Oncol. 2006;78:254–261
  28. Moureau-Zabotto L, Touboul E, Lerouge D, et al. Impact of CT and 18F-fluorodeoxyglucose positron emission tomography image fusion for conformal radiotherapy in esophageal carcinoma. Int J Radiat Oncol Biol Phys. 2005;63:340–345
  29. Muijs CT, Schreurs LM, Busz DM, et al. Consequences of additional use of PET information for target volume delineation and radiotherapy dose distribution for esophageal cancer. Radiother Oncol. 2009;93:447–453
  30. Siewert JR, Stein HJ. Classification of adenocarcinoma of the oesophagogastric junction. Br J Surg. 1998;85:1457–1459
  31. Power DG, Reynolds JV. Localized adenocarcinoma of the esophagogastric junction - Is there a standard of care?. Cancer Treat Rev. 2010;[Epub ahead of print]
  32. Matzinger O, Gerber E, Bernstein Z, et al. EORTC-ROG expert opinion: radiotherapy volume and treatment guidelines for neoadjuvant radiation of adenocarcinomas of the gastroesophageal junction and the stomach. Radiother Oncol. 2009;92:164–175
  33. Weber WA, Ott K, Becker K, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging. J Clin Oncol. 2001;19:3058–3065
  34. Ott K, Weber WA, Lordick F, et al. Metabolic imaging predicts response, survival and recurrence in adenocarcinomas of the esophagogastri junction. J Clin Oncol. 2006;24:4692–4698
  35. Lordick F, Ott K, Krause BJ, et al. PET to assess early metabolic response and to guide treatment of adenocarcinoma of the oesophagogastric junction: the MUNICON phase II trial. Lancet Oncol. 2007;8:797–805
  36. Sobin LH, Gospodarowicz MK, Wittekind C. TNM Classification of Malignant Tumours. 7th ed.. New York: Wiley; 2009;
  37. Han D, Yu J, Yu Y, et al. Comparison of (18)F-fluorothymidine and (18)F-fluorodeoxyglucose PET/CT in delineating gross tumor volume by optimal threshold in patients with squamous cell carcinoma of thoracic esophagus. Int J Radiat Oncol Biol Phys. 2010;15:1235–1241
  38. Macdonald JS, Smalley SR, Benedetti J. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345:725–730
  39. Yun M, Lim JS, Noh SH, et al. Lymph node staging of gastric cancer using 18F-FDG PET: A comparison study with CT. J Nucl Med. 2005;46:1582–1588
  40. Mukai K, Ishida Y, Okajima K, Isozaki H, Morimoto T, Nishiyama S. Usefulness of preoperative FDG-PET for detection of gastric cancer. Gastric cancer. 2006;9:192–196
  41. Stahl A, Ott K, Weber WA, et al. FDG-PET imaging of locally advanced gastric carcinomas: correlation with endoscopic and histopathological findings. Eur J Nucl Med Mol Imaging. 2003;30:288–295
  42. Yang Q-M, Kawamura T, Itoh H, et al. Is PET-CT suitable for predicting lymph node status for gastric cancer?. Hepatogastroenterology. 2008;33:782–785
  43. Ott K, Fink U, Becker K, et al. Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: Results of a prospective trial. J Clin Oncol. 2003;21:4604–4610
  44. Di Fabio F, Pinto C, Rojas Llimpe FL, et al. The predictive value of 18F-FDG-PET early evalution in patients with metastatic gastric adenocarcinoma treated with chemotherapy plus cetuximab. Gastric Cancer. 2007;10:221–227
  45. Hermann K, Ott K, Buck AK, et al. Imaging gastric cancer with PET and the radiotracers 18F-FLT and 18F-FDG: a comparative analysis. J Nucl Med. 2007;48:1945–1950
  46. Moertel C, Frytak S, Hahn R, et al. Therapy of locally unresectable pancreatic carcinoma: a randomized comparison of high dose (6000 rads) radiation alone, moderated dose radiation (4000 rads)5-fluorouracil and high dose radiation 5-fluorouracil: the gastrointestinal tumor study group. Cancer. 1981;48:1705–1710
  47. Huguet F, Girard N, Seblain-El Guerche C, et al. Chemoradiotherapy in the management of locally advanced pancreatic carcinoma: a qualitative systematic review. J Clin Oncol. 2009;27:2269–2277
  48. Rusthoven KE, Kavanagh BD, Cardenes H, et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol. 2009;27:1572–1578
  49. Koong AC, Christofferson E, Le QT, et al. Phase II study to assess the efficacy of conventionally fractionated radiotherapy followed by a stereotactic radiosurgery boost in patients with locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys. 2005;63:230–323
  50. Chang DT, Schellenberg D, Shen J, et al. Stereotactic radiotherapy for unresectable adenocarcinoma of the pancreas. Cancer. 2009;115:665–672
  51. Schellenberg D, Quon A, Minn AY, et al. (18)Fluorodeoxyglucose PET is prognostic of progression-free and overall survival in locally advanced pancreas cancer treated with stereotactic radiotherapy. Int J Radiat Oncol Bio Phys. 2010;77:1420–1425
  52. Schellenberg D, Goodman KA, Lee Florence, et al. Gemcitabine chemotherapy and single-fraction stereotactic body radiotherapy for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys. 2008;72:678–686
  53. Ford EC, Hermans J, Yorke E, Wahl RL. 18FDG-PET/CT for image-Guided and intensity-modulated Radiotherapy. J Nucl Med. 2009;50:1655–1665
  54. Quon A, Chang ST, Chin F, et al. Initial evaluation of 18F-fluorothymidine (FLT) PET/CT scanning for primary pancreatic cancer. Eur J Nucl Med Mol Imaging. 2008;35:527–531
  55. Dawson LA, McGinn CJ, Tenhaken RK, Walker S, Ensminger W, Lawrence TS. Escalated focal liver radiation and concurrent hepatic artery fluorodeoxyuridine for unresectable intrahepatic malignancies. J Clin Oncol. 2000;18:2210–2218
  56. Wulf J, Guckenberger M, Haedinger U, et al. Stereotactic radiotherapy of primary liver cancer and hepatic metastases. Acta Oncol. 2006;45:897–906
  57. Tse RV, Hawkins M, Lockwood G. Phase I study of individualized stereotactic body radiotherapy for hepatocellular carcinoma and intrahepatic cholangiocarcinoma. J Clin Oncol. 2008;26:657–664
  58. Ricke J, Wust P, Stohlmann A, et al. CT-guided interstitial brachytherapy of liver malignancies alone or in combination with thermal ablation: Phase I-II results of a novel technique. Int J Radiat Oncol Biol Phys. 2004;58:1496–1505
  59. Lee MT, Kim JJ, Dinniwell R. Phase I study of individualized stereotactic body radiotherapy of liver metastasis. J Clin Oncol. 2009;27:1585–1591
  60. Khan MA, Combs CS, Brunt EM, et al. Positron emission tomography scanning in the evaluation of hepatocellular carcinoma. J Hepatology. 2000;32:792–797
  61. Jeng LB, Changlai SP, Shen YY, Lin CC, Tsai CH, Tsai CH. Limited value of 18F–2 deoxyglucose positron emission tomography to detect hepatocellular carcinoma in hepatitis B virus carriers. Hepatogastroenterology. 2003;50:2154–2156
  62. Teefey SA, Hildeboldt CC, Dehdashti F, et al. Detection of primary hepatic malignancy in liver transplant candidates: prospective comparison of CT, MR imagin US and PET. Radiology. 2003;226:533–542
  63. Ho C, Yu S, Yeung D. 11C-Acetate PET imaging in hepatocellular carcinoma and other liver masses. J Nucl Med. 2003;44:213–221
  64. Park JW, Kim JH, Kim SK, et al. A prospective Evaluation of 18FDG and 11C-acetate PET/CT for detection of primary and metastatic hepatocellular carcinoma. J Nucl Med. 2008;49:1912–1921
  65. Talbot J, Gutman F, Fartoux L, et al. PET/CT in patients with hepatocellular carcinoma using 18[F] fluorocholine: preliminary comparison with 18[F]FDG PET/CT. Eur J Nucl Med Mol Imaging. 2006;33:1285–1289
  66. Adson MA, van Heerden JA, Adson MH, et al. Resection of hepatic metastases from colorectal cancer. Arch Surg. 1984;119:647–651
  67. Ogunbiyi OA, Flanagan FL, Dehdashti F, et al. Detection of recurrent and metastatic colorectal cancer: comparison of positron emission tomography and computed tomography. Ann Surg Oncol. 1997;4:613–620
  68. Flamen P, Stroobants S, Van Cutsm E. Additional value of whole-body positron emission tomography with fluorine-18–2-fluoro-deoxy-d-glucose in recurrent colorectal cancer. J Clin Oncol. 1997;17:894–901
  69. Fernandez FG, Drebin JA, Linehan DC, et al. Five-Year Survival After Resection of Hepatic Metastases From Colorectal Cancer in Patients Screened by Positron Emission Tomography With F-18 Fluorodeoxyglucose (FDG-PET). Ann Surg. 2004;240:438–450
  70. Steffen IG, Wust P, Ruehl R, et al. Value of combined PET/CT for radiation planning in CT-Guided percutaneous interstitial high-dose-rate single-fraction brachytherapy for colorectal liver metastases. Int J Radiat Oncol Biol Phys. 2010;77:1178–1185
  71. Akhurst T, Kates TJ, Mazumdar M, et al. Recent chemotherapy reduces the sensitivity of 18F Fluorodeoxyglucose positron emission tomography in the detection of colorectal metastases. J Clin Oncol. 2005;23:8713–8716
  72. Sauer R, Becker H, Hohenberger W, et al. German Rectal Cancer Study Group Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731–1740
  73. Roels S, Duthoy W, Haustermans K, Penninckx F, Vandecaveye V, Boterberg T, et al. Definition and delineation of the clinical target volume for rectal cancer. Int J Radiat Oncol Biol Phys. 2006;65:1129–1142
  74. Habr-Gama A, Perez RO, Nadalin W, et al. Operative versus non operative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results. Ann Surg. 2004;240:711–717
  75. Bujko K, Richter P, Kołodziejczyk M, et al. Preoperative radiotherapy and local excision of rectal cancer with immediate radical re-operation for poor responders. Radiother Oncol. 2009;92:195–201
  76. Engels B, De Ridder M, Tournel K, et al. Preoperative helical tomotherapy and megavoltage computed tomography for rectal cancer: impact on the irradiated volume of small bowel. Int J Radiat Oncol Biol Phys. 2009;5:1476–1480
  77. Roels S, Slagmolen P, Nuyts J, et al. Biological image-guided radiotherapy in rectal cancer: is there a role for FMISO or FLT, next to FDG?. Acta Oncol. 2008;47:1237–1248
  78. Ciernik IF, Huser M, Burger C, Bernard Davis J, Szekely G. Automated functional image-guided radiation treatment planning for rectal cancer. Int J Radiat Oncol Biol Phys. 2005;62:893–900
  79. Roels S, Haustermans K, Gregoir V. In regard to Ciernik et al. Automated functional image-guided radiation treatment planning for rectal cancer. Int J Radiat Oncol Biol Phys. 2006;64:1611–1615
  80. International Commission on Radiation Units and Measurements, ICRU Report 50: dose specification for reporting external beam therapy with photons and electrons, ICRU, Bethesda, MD; 1993.
  81. Patel DA, Chang ST, Goodman KA. Impact of Integrated PET/CT on variability of target volume delineation in rectal cancer. Technol Cancer Res Treat. 2007;6:31–36
  82. Nigro ND, Vaitkevicius VK, Consisine B. Combined therapy for cancer of the anal canal: a preliminary report. Dis colon Rectum. 1974;17:354–356
  83. Bartelink H, Roelofsen F, Eschwege F, et al. Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal cooperative Groups. J Clin Oncol. 1997;15:2040–2049
  84. Cotter SE, Grigsby PW, Siegel BA, et al. FDG-PET/CT in the evaluation of anal carcinoma. Int J Radiat Oncol Biol Phys. 2006;65:720–725
  85. Nguyen BT, Joon DL, Khoo V, et al. Assessing the impact of FDG-PET in the management of anal cancer. Radiother Oncol. 2008;87:376–382
  86. Schwarz JK, Siegel BA, Dehdashti F, et al. Tumor response and survival predicted by post-therapy FDG-PET/CT in anal cancer. Int J Radiat Oncol BIol Phys. 2008;71:180–186
  87. Mai SK, Welzel G, Hermann B, Wenz F, Haberkorn U, Dinter DJ. Can the radiation dose to CT-enlarged buy FDG-PET-negative inguinal lymph nodes in anal cancer be reduced?. Strahlenther Onkol. 2009;185:254–259

PII: S0167-8140(10)00446-9

doi: 10.1016/j.radonc.2010.07.019

Radiotherapy & Oncology
Volume 96, Issue 3 , Pages 339-346 , September 2010