Table 1.
FDG-PET-related alteration of target volumes in NSCLC.
| Reference | Stage | Volume changes due to FDG-PET | Dosimetric impact |
|---|---|---|---|
| Nestle et al. (6) | IIIB-IV | Change in size and shape of radiation fields: 35% | |
| Field size reduction: 26% (median 19.3%) | |||
| More changes observed in the presence of atelectasis (p = 0.03) | |||
| Erdi et al. (7) | Unknown | PTV increase (additional nodal disease): 19%a | Mean heart dose decreased by 50% in the PET plan in one case |
| PTV reduction: 18%a | |||
| Mah et al. (8) | III (2/7) | Stage alteration: 23% | Maximum spinal cord dose is decreased on average with PET/CT-based planning (p ≤ 0.01) |
| PTV reduction and increase among three observers: 24–70 and 30–76% | |||
| Bradley et al. (9) | I–III (65% stage III) | Stage alteration: 31% | Alteration of the GTV led to corresponding changes in the dose to the esophagus and the normal lungs |
| PTV alteration: 58% | |||
| GTV reduction (atelectasis): 12% | |||
| GTV increase (additional primary and nodal disease): 46% | |||
| van Der Wel et al. (10) | III | Nodal GTV decreased by 3.8 cm3 on average (p = 0.011) Radiation field change: 66.7% (decreased in 52.4%, increased in 14.3%) | Alteration of the GTV led to corresponding changes in dose to the esophagus and the normal lungs |
| PET enabled dose escalation from 56 Gy to 71 Gy on average (p = 0.038) & increased TCP by at least 6% on average (p < 0.05) | |||
| Ceresoli et al. (11) | 66.7% III | Stage alteration: 48% ≥25% change in GTV: 39% | Dose reduction to the spinal cord was observed in PET plans (median 41.7 Gy vs. 45.7 Gy, p < 0.05) |
| Changes in GTV led to corresponding changes in dose to normal lung tissue | |||
| 5/7 with GTV increase (additional nodal disease) | |||
| 2/7 with GTV reduction (PET negative enlarged LN and atelectasis) | |||
| Faria et al. (13) | Stage alteration: 44% | ||
| GTV alteration: 56% | |||
| Decrease: 37.3% | |||
| Increase: 18.7% | |||
| Yin et al. (14) | IIIb | GTV alteration: 100% (≥25 in 40% of patients) | PET led to significant changes in V20, V30 for the lungs and V50, V55 of the esophagus |
| Decrease: 73.3% (155.1–111.4 cm3c) | |||
| Increase: 26.7% (125.8–144.7 cm3c) |
aAverage; TCP, tumor control probability.
bAtelectasis present in all patients.
cMedian.