Scientific article

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

Published inRadiotherapy and oncology, vol. 93, no. 2, p. 220-225
Publication date2009

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.

  • Aged
  • Aged, 80 and over
  • Choline/*analogs & derivatives/diagnostic use
  • Fluorine Radioisotopes/*diagnostic use
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local/*radiotherapy
  • *Positron-Emission Tomography
  • Prostatic Neoplasms/radionuclide imaging/*radiotherapy
  • Radiopharmaceuticals/*diagnostic use
  • Radiotherapy Dosage
  • Tomography, X-Ray Computed
Citation (ISO format)
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
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ISSN of the journal0167-8140

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