{"title":"PET/CT findings and dose distribution during radiotherapy in T1N0M0-T2N0M0 glottic cancer.","authors":"Yukinori Okada, Tatsuhiko Zama, Tomohiro Itonaga, Ryuji Mikami, Mitsuru Okubo, Shinji Sugahara, Masahiko Kurooka, Motoki Nakai, Koichiro Abe, Mana Yoshimura, Kazuhiro Saito","doi":"10.1967/s002449912710","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the positron emission tomography/computed tomography (PET/CT) findings of T1/T2N0M0 glottic cancer (hereafter referred to as T1/T2) and dose distribution in radiotherapy.</p><p><strong>Subjects and methods: </strong>We retrospectively collected data from patients diagnosed with T1/T2N0M0 glottic cancer who received radiotherapy. The extent of fluorine-18-fluorodeoxyglucose (<sup>18</sup>F-FDG) accumulation in primary tumors, maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), tumor volume of primary tumors on PET/CT were compared. Furthermore, the tumor identified on PET/CT was incorporated into the radiotherapy plans. A dummy plan (radiation field 6x6cm, prescription point facing the vertebral body, maximum dose ≤107%, T1/T2 66Gy/33 fractions) was developed for three-dimensional conformal radiotherapy, and the dose distribution of primary tumors was calculated.</p><p><strong>Results: </strong>Twenty-nine patients (27 men and two women) were included; their mean age was 67.2±15.0 years. Increased <sup>18</sup>F-FDG accumulation in primary tumors was observed on PET/CT in 22/29 (78.5%; T1: 14/21 [67%], T2: 8/8 [100%]) patients. The median SUVmax, TLG, and primary tumor volume were significantly different between T1 and T2 (SUVmax, T1: 4.56 vs. T2: 8.43, P=0.035; TLG, T1: 1.01 vs. T2: 3.71 SUVxmL, P<0.01; primary tumor volume, T1: 0.38mL vs. T2: 0.80mL, P=0.01). At a TLG cut-off value of 3.470, the area under the curve was 0.875, sensitivity was 0.875, and specificity was 0.929 for T1-T2 differentiation. In 20 patients with <sup>18</sup>F-FDG accumulation, the minimum radiation dose was significantly different between T1 and T2 (66Gy vs. 64Gy, P<0.01) at the same 66Gy prescription. The minimum radiation dose and primary tumor volume show the correlation value (r=-0.516, P=0.02).</p><p><strong>Conclusion: </strong>In glottic cancer, T1 and T2 can be differentiated by the extent of <sup>18</sup>F-FDG accumulation in primary tumors on PET/CT. The minimum radiation dose rate decreases as volume increases.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"27 1","pages":"27-34"},"PeriodicalIF":0.9000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hellenic journal of nuclear medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1967/s002449912710","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To investigate the positron emission tomography/computed tomography (PET/CT) findings of T1/T2N0M0 glottic cancer (hereafter referred to as T1/T2) and dose distribution in radiotherapy.
Subjects and methods: We retrospectively collected data from patients diagnosed with T1/T2N0M0 glottic cancer who received radiotherapy. The extent of fluorine-18-fluorodeoxyglucose (18F-FDG) accumulation in primary tumors, maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), tumor volume of primary tumors on PET/CT were compared. Furthermore, the tumor identified on PET/CT was incorporated into the radiotherapy plans. A dummy plan (radiation field 6x6cm, prescription point facing the vertebral body, maximum dose ≤107%, T1/T2 66Gy/33 fractions) was developed for three-dimensional conformal radiotherapy, and the dose distribution of primary tumors was calculated.
Results: Twenty-nine patients (27 men and two women) were included; their mean age was 67.2±15.0 years. Increased 18F-FDG accumulation in primary tumors was observed on PET/CT in 22/29 (78.5%; T1: 14/21 [67%], T2: 8/8 [100%]) patients. The median SUVmax, TLG, and primary tumor volume were significantly different between T1 and T2 (SUVmax, T1: 4.56 vs. T2: 8.43, P=0.035; TLG, T1: 1.01 vs. T2: 3.71 SUVxmL, P<0.01; primary tumor volume, T1: 0.38mL vs. T2: 0.80mL, P=0.01). At a TLG cut-off value of 3.470, the area under the curve was 0.875, sensitivity was 0.875, and specificity was 0.929 for T1-T2 differentiation. In 20 patients with 18F-FDG accumulation, the minimum radiation dose was significantly different between T1 and T2 (66Gy vs. 64Gy, P<0.01) at the same 66Gy prescription. The minimum radiation dose and primary tumor volume show the correlation value (r=-0.516, P=0.02).
Conclusion: In glottic cancer, T1 and T2 can be differentiated by the extent of 18F-FDG accumulation in primary tumors on PET/CT. The minimum radiation dose rate decreases as volume increases.
期刊介绍:
The Hellenic Journal of Nuclear Medicine published by the Hellenic Society of
Nuclear Medicine in Thessaloniki, aims to contribute to research, to education and
cover the scientific and professional interests of physicians, in the field of nuclear
medicine and in medicine in general. The journal may publish papers of nuclear
medicine and also papers that refer to related subjects as dosimetry, computer science,
targeting of gene expression, radioimmunoassay, radiation protection, biology, cell
trafficking, related historical brief reviews and other related subjects. Original papers
are preferred. The journal may after special agreement publish supplements covering
important subjects, dully reviewed and subscripted separately.