[68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning

Radiation Oncology - Tập 4 Số 1 - 2009
Barbara Gehler1, Frank Paulsen1, Mehmet Ö. Öksüz2, Till‐Karsten Hauser3, Susanne Martina Eschmann4, Roland Bares2, Christina Pfannenberg5, M. Bamberg1, Peter Bartenstein6, Claus Belka7, Ute Ganswindt7
1Department of Radiation Oncology, University of Tübingen, Tübingen, 72076, Germany
2Department of Nuclear Medicine, University of Tübingen, Tübingen, 72076, Germany
3Department of Neuroradiology, University of Tübingen, Tübingen, 72076, Germany
4Medizinisches Versorgungszentrum Nuklearmedizin, Stuttgart, 70199, Germany
5Department of Radiology, University of Tübingen, Tübingen, 72076, Germany
6Department of Nuclear Medicine, LMU München, München, 81377, Germany
7Department of Radiation Oncology, LMU München, München, 81377, Germany

Tóm tắt

Abstract Purpose The observation that human meningioma cells strongly express somatostatin receptor (SSTR 2) was the rationale to analyze retrospectively in how far DOTATOC PET/CT is helpful to improve target volume delineation for intensity modulated radiotherapy (IMRT). Patients and Methods In 26 consecutive patients with preferentially skull base meningioma, diagnostic magnetic resonance imaging (MRI) and planning-computed tomography (CT) was complemented with data from [68Ga]-DOTA-D Phe1-Tyr3-Octreotide (DOTATOC)-PET/CT. Image fusion of PET/CT, diagnostic computed tomography, MRI and radiotherapy planning CT as well as target volume delineation was performed with OTP-Masterplan®. Initial gross tumor volume (GTV) definition was based on MRI data only and was secondarily complemented with DOTATOC-PET information. Irradiation was performed as EUD based IMRT, using the Hyperion Software package. Results The integration of the DOTATOC data led to additional information concerning tumor extension in 17 of 26 patients (65%). There were major changes of the clinical target volume (CTV) which modify the PTV in 14 patients, minor changes were realized in 3 patients. Overall the GTV-MRI/CT was larger than the GTV-PET in 10 patients (38%), smaller in 13 patients (50%) and almost the same in 3 patients (12%). Most of the adaptations were performed in close vicinity to bony skull base structures or after complex surgery. Median GTV based on MRI was 18.1 cc, based on PET 25.3 cc and subsequently the CTV was 37.4 cc. Radiation planning and treatment of the DOTATOC-adapted volumes was feasible. Conclusion DOTATOC-PET/CT information may strongly complement patho-anatomical data from MRI and CT in cases with complex meningioma and is thus helpful for improved target volume delineation especially for skull base manifestations and recurrent disease after surgery.

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Radiation Oncology

Tập 4 Số 1

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