PET/CT of Cancer Patients: Part 2, Deformable Registration Imaging Before and After Chemotherapy for Radiation Treatment Planning in Head and Neck Cancer

Harvard Radiation Oncology Program, Boston, MA.
American Journal of Roentgenology (Impact Factor: 2.73). 11/2012; 199(5):968-74. DOI: 10.2214/AJR.12.8562
Source: PubMed


The purpose of this perspective is to discuss the use of deformable registration as a tool for image fusion to integrate information from PET/CT scans obtained before and after chemotherapy to assist definition of radiation targets in the management of head and neck cancer.

The consistent method for target delineation described capitalizes on the capability of deformable registration to compensate for changes in position and accurately represent evolving spatial relationships between normal anatomy and areas at risk of disease.

9 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In head and neck oncology, the information provided by positron emission tomography (PET)/CT and MRI is often complementary because both the methods are based on different biophysical foundations. Therefore, combining diagnostic information from both modalities can provide additional diagnostic gain. Debates about integrated PET/MRI systems have become fashionable during the past few years, since the introduction and wide adoption of software-based multimodality image registration and fusion and the hardware implementation of integrated hybrid PET/MRI systems in pre-clinical and clinical settings. However, combining PET with MRI has proven to be technically and clinically more challenging than initially expected and, as such, research into the potential clinical role of PET/MRI in comparison with PET/CT, diffusion-weighted MRI (DW MRI) or the combination thereof is still ongoing. This review focuses on the clinical applications of PET/MRI in head and neck squamous cell carcinoma (HNSCC). We first discuss current evidence about the use of combined PET/CT and DW MRI, and, then, we explain the rationale and principles of PET/MR image fusion before summarizing the state-of-the-art knowledge regarding the diagnostic performance of PET/MRI in HNSCC. Feasibility and quantification issues, diagnostic pitfalls and challenges in clinical settings as well as ongoing research and potential future applications are also discussed.
    Full-text · Article · Apr 2014 · The British journal of radiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Incorporation of PET/computed tomography (CT) in radiotherapy planning plays a critical role in assisting gross tumor volume delineation for radiotherapy planning and delivery. As radiotherapy techniques evolve to become more conformal with the increasing use of intensity-modulated radiotherapy and stereotactic body radiotherapy, whereby sharp dose gradients exist between the target and adjacent normal tissue, accurate contouring of tumor targets is vital for the success of radiotherapy to achieve cure and locoregional control. This article outlines the integration of PET/CT into radiotherapy planning for head and neck, lung, and other solid tumors. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Feb 2015 · PET Clinics
  • [Show abstract] [Hide abstract]
    ABSTRACT: 18F-FDG-PET-CT has showed its utility in the staging and the definition of the treatment volume in head and neck cancers with radiotherapy (RT) indication. Despite some uncertainties related to resolution and segmentation, PET/CT offers valuable information about tumor heterogeneity and biology. The technological advances in the radiotherapy setting as intensity-modulated RT, image-guided RT in the adaptive protocol and dose escalation are the future directions for the PET-CT especially for hypoxia or proliferation radiotracers.
    No preview · Article · Jul 2015
Show more