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18F-fluorocholine PET-guided target volume delineation techniques for partial prostate re-irradiation in local recurrent prostate cancer

Vees, Hansjorg
Steiner, Charles
Senthamizhchelvan, Srinivasan
Published in Radiotherapy and oncology. 2009, vol. 93, no. 2, p. 220-225
Abstract BACKGROUND AND PURPOSE: We evaluate the contribution of (18)F-choline PET/CT in the delineation of gross tumour volume (GTV) in local recurrent prostate cancer after initial irradiation using various PET image segmentation techniques. MATERIALS AND METHODS: Seventeen patients with local-only recurrent prostate cancer (median=5.7 years) after initial irradiation were included in the study. Rebiopsies were performed in 10 patients that confirmed the local recurrence. Following injection of 300 MBq of (18)F-fluorocholine, dynamic PET frames (3 min each) were reconstructed from the list-mode acquisition. Five PET image segmentation techniques were used to delineate the (18)F-choline-based GTVs. These included manual delineation of contours (GTV(man)) by two teams consisting of a radiation oncologist and a nuclear medicine physician each, a fixed threshold of 40% and 50% of the maximum signal intensity (GTV(40%) and GTV(50%)), signal-to-background ratio-based adaptive thresholding (GTV(SBR)), and a region growing (GTV(RG)) algorithm. Geographic mismatches between the GTVs were also assessed using overlap analysis. RESULTS: Inter-observer variability for manual delineation of GTVs was high but not statistically significant (p=0.459). In addition, the volumes and shapes of GTVs delineated using semi-automated techniques were significantly higher than those of GTVs defined manually. CONCLUSIONS: Semi-automated segmentation techniques for (18)F-choline PET-guided GTV delineation resulted in substantially higher GTVs compared to manual delineation and might replace the latter for determination of recurrent prostate cancer for partial prostate re-irradiation. The selection of the most appropriate segmentation algorithm still needs to be determined.
Keywords AgedAged, 80 and overCholine/*analogs & derivatives/diagnostic useFluorine Radioisotopes/*diagnostic useHumansMaleMiddle AgedNeoplasm Recurrence, Local/*radiotherapy*Positron-Emission TomographyProstatic Neoplasms/radionuclide imaging/*radiotherapyRadiopharmaceuticals/*diagnostic useRadiotherapy DosageTomography, X-Ray Computed
PMID: 19767115
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Research groups Groupe Mirabell Raymond (radio-oncologie) (685)
Groupe Ratib Osman (nouvelles techniques d'imagerie moléculaire) (819)
Imagerie Médicale (TEP et TEMP) (542)
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WANG, Hui et al. 18F-fluorocholine PET-guided target volume delineation techniques for partial prostate re-irradiation in local recurrent prostate cancer. In: Radiotherapy and oncology, 2009, vol. 93, n° 2, p. 220-225. doi: 10.1016/j.radonc.2009.08.037 https://archive-ouverte.unige.ch/unige:20169

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Deposited on : 2012-04-23

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