18FDG-PET/CT Definition of Clinical Target Volume for Robotic Stereotactic Body Radiosurgery Treatment of Metastatic Gynecologic Malignancies
- Corresponding Author:
- Charles A. Kunos, MD, PhD
Department of Radiation Oncology
University Hospitals of Cleveland
11100 Euclid Avenue, LTR 6068
Cleveland, Ohio 44106 USA
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.
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.