Evaluation of the impact of integrated [18f]-fluoro- 2-deoxy-D-glucose positron emission tomography/ computed tomography imaging on staging and radiotherapy treatment volume definition of non- small cell lung cancer

The aim of this study was to evaluate the impact of integrated positron emission tomography (PET)/computed tomography (CT) imaging on staging and radiotherapy treatment volume definition of non-small cell lung cancer (NSCLC). Thirty-nine patients with NSCLC referred to the Department of Radiation Oncology of Gulhane Military Medical Academy, for radical radiotherapy between June 2011 and December 2011 were enrolled in this study. All patients underwent integrated PET/CT imaging in treatment position for initial assessment. For patients deemed suitable for radical radiotherapy, CTbased and integrated PET/CT imaging based radiotherapy treatment plans were generated to comparatively evaluate dose-volume parameters of both plans. Of the 39 patients initially assessed with integrated PET/CT imaging, 29 patients (74.4%) were deemed suitable for radical radiotherapy with curative intent. Fifteen patients (38.5%) were upstaged after integrated PET/CT staging. Of the 29 patients treated with radical radiotherapy at our department using integrated PET/CT imaging based radiation treatment planning (RTP), gross tumor volume was decreased in 16 patients (55.2%) and increased in 13 patients (44.8%) by incorporating PET/CT into RTP. Integrated PET/CT imaging allows selection of patients eligible for radical radiotherapy along with tailoring of radiotherapy target volumes to prevent overtreatment and undertreatment.