Automatic Segmentation of the Gross Tumor Volume in Prostate Carcinoma Using Fuzzy Clustering in Gallium-68 PSMA PET/CT Scan

Introduction: Modern radiotherapy (RT) techniques allow a highly precise deposition of the radiation dose in tumor. So, high conformal tumor doses can be reached while sparing critical organs at risk. Materials and Methods: This study was conducted in three phases. In the first phase; Fourteen patients with primary or recurrent prostate cancer receive Gallium-68 PSMA PET/CT planned 3D conformal or intensity modulated radio therapy. In the second phase; fuzzy clustering method to definition the gross volume tumor in prostate. In the next phase; increasing the dose in the tumor according to the functional and molecular information assessed by combined PET/CT imaging and result of clustering. Result: The mean standard uptake value (Suv) was 6.2 in the lesion of the prostate. To administer 75.6Gy to the entire prostate with a boost dose to 84Gy, was feasible. Conclusion: The additional of the simultaneous integrated boost(SIB) was associated with greater control but not toxicity.