WANG Dan,LIU Ming-yuan,XIU Xia.Effect of radiotherapy planning using different methods PET-CT defining the target volumes for lung cancer patients[J].Chinese Journal of Radiological Medicine and Protection,2008,28(4):368-370
Effect of radiotherapy planning using different methods PET-CT defining the target volumes for lung cancer patients
Received:October 25, 2007  
DOI:
KeyWords:Lung neoplasms  Radiotherapy  Positron emission tomography  X-ray computed tomography  Target volume delineation
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Author NameAffiliation
WANG Dan Department of Radiation Oncology, Beijing Hospital, Beijing 100730, China 
LIU Ming-yuan Department of Radiation Oncology, Beijing Hospital, Beijing 100730, China 
XIU Xia Department of Radiation Oncology, Beijing Hospital, Beijing 100730, China 
高鸿 Department of Radiation Oncology, Beijing Hospital, Beijing 100730, China 
李高峰 Department of Radiation Oncology, Beijing Hospital, Beijing 100730, China 
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Abstract::
      Objective To investigate the effect of target volume and normal tissues dose in lung cancer patients with PET-CT of different delineation methods. Methods Two patients were chosen. After PET-CT scan, the images were transferred to the radiotherapy planning system (Varian Eclipse) for images fusion and treatment planning design. The three gross tumor volumes (GTVs) were defined using a threshold value of 50% of Kmax of the whole lesion(GTV50), a threshold value of 40% of Kmax of the whole lesion (GTV40) and a threshold value of SUV=2.5 (GTV2.5), respectively. The Kmax was the maximum voxel value of PET activity (Bq/ml). The planning target volumes (PTVs) were obtained by addition of an 1.5cm around the GTV. The normal tissues were defined, including the total lung and spinal cord. Dose distribution was computed for the other two PTVs. Plans were compared using dose volume histograms for lung and spinal cord.Results The results of three methods were different in two patients. The GTVs were 23.1,34.9,49.2 cm3 and 58.1,80.3,163.4 cm3, respectively. The PTVs were 169.5, 222.1, 261.9 cm3 and 286.8,349.7,560.5 cm3, respectively. The percentages of whole lung that received a dose of 20 Gy or more were 14.4%,17.2%,19.5% and 15.2%,16.0%, 20.2%,respectively. The mean lung dose were 16.2%,19.4%,21.4% and 12.7%,4.4%,19.4%. The doses of ≤1 cm3 spinal cord were 30.6%,34.3%,44.9% and 27.3%,35.2%,67.1%.Conclusions The effect of target volume and normal tissues dose in lung cancer patients with PET-CT of different delineation methods were significant. The threshold value that can cover tumor more completely should be used to define target volumes for radiotherapy when the normal tissues can accepted tolerance dose.
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