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18FDG-PET/CT Definition of Clinical Target Volume for Robotic Stereotactic Body Radiosurgery Treatment of Metastatic Gynecologic Malignancies | OMICS International | Abstract
ISSN: 2155-9619

Journal of Nuclear Medicine & Radiation Therapy
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Research Article

18FDG-PET/CT Definition of Clinical Target Volume for Robotic Stereotactic Body Radiosurgery Treatment of Metastatic Gynecologic Malignancies

Charles A. Kunos1*, Robert Debernardo2, Jeffrey Fabien MS1, Donald C. Dobbins1, Yuxia Zhang1, James Brindle1 and Peter F. Faulhaber3

1Departments of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA

2Obstetrics and Gynecology Division of Gynecologic Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA

3Radiology Division of Nuclear Medicine, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA

Corresponding Author:
Charles A. Kunos, MD, PhD
Department of Radiation Oncology
University Hospitals of Cleveland
11100 Euclid Avenue, LTR 6068
Cleveland, Ohio 44106 USA
Tel: 216-844-3103
Fax: 216-844-2005
E-mail: [email protected]

Received Date: November 21, 2011; Accepted Date: December 06, 2011; Published Date: December 12, 2011

Citation: Kunos CA, Debernardo R, Fabien MSJ, Dobbins DC, Zhang Y, et al. (2011) 18FDG-PET/CT Definition of Clinical Target Volume for Robotic Stereotactic Body Radiosurgery Treatment of Metastatic Gynecologic Malignancies. J Nucl Med Radiat Ther S4:001. doi:10.4172/2155-9619.S4-001

Copyright: © 2011 Kunos CA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The objective of the current article was to evaluate 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) as measured by positron emission tomography for delineation of abdominopelvic gross tumor volumes (GTV) for stereotactic body radiosurgery treatment (SBRT) of metastatic gynecologic cancers. A retrospective review of SBRT was conducted in 27 women with stage IV gynecologic cancers recurring in para-aortic lymph nodes. Robotic SBRT involved 2400 cGy in 3 consecutive 800 cGy daily fractions prescribed to a 3.0 mm expanded planning tumor volume (PTV) defined by both CT-based and 18F-FDG-based GTVs. In this study, 18F-FDG-based GTVs led to significantly larger PTVs in all 27 women, than if they had been based on CT GTVs alone (P < 0.001). Enlarged PTVs may have resulted from the breathing-induced target motion during the time of 18F-FDG image acquisition smearing 18F-FDG signal over a greater anatomic dimension. Ultimately, SBRT-target local control, based on the RECIST 1.1 criteria, was 96% (26 of 27), and associated with minor reversible toxicity. The use of 18F-FDG to define SBRT target volumes warrants further interrogation in SBRT clinical trials.

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