PET/CT for radiotherapy planning of head-Ã¢ÂÂneck cancer

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Increase therapeuAc raAo • Increase tumour sensitivity to irradiation • eg add chemotherapy, decrease hypoxia • Decrease normal tissue sensitivity to irradiation • eg amifostine • Increase conformality of irradiation • Focus on tumour • Avoid organs at risk This is where PET comes into play Slide 24 / 86
GTV Gross Tumor Volume based on: Imaging modalities Diagnostic modalities (pathology/histology) Clinical examination Slide 25 / 86
Page 1 and 2: Dr. Wouter V. Vogel Department of N
Page 3 and 4: Topics ! Why PET/CT ? ! Diagnos3c v
Page 5 and 6: Anatomical imaging with CT Based on
Page 7 and 8: Molecular imaging ! Is a visual fun
Page 9 and 10: Reasons to perform PET/CT ! Does th
Page 11 and 12: Are there nodal metastases? DetecAo
Page 13 and 14: Are there distant metastases? For t
Page 15 and 16: MulAmodality more than nice colors
Page 17 and 18: MulAmodality: the greater perspecAv
Page 19: Planar image fusion 1953 Thyroid sc
Page 22 and 23: Radiotherapy what do we need?
Page 26 and 27: CTV Clinical Target Volume GTV with
Page 28 and 29: RT planning process Item Item 1 •
Page 30 and 31: Sources of errors Inaccurate beam d
Page 32: PotenAal problems PET/CT imaging ca
Page 35 and 36: StandardizaAon of PET/CT imaging !
Page 37 and 38: AddiAonal paAent posiAoning Repeate
Page 39 and 40: Head/neck Required ! Flat table ! C
Page 41 and 42: Example: NO MASK Please don’t try
Page 43 and 44: Example: SubopAmal mask placement V
Page 45 and 46: Example: Success Results ! Image re
Page 47 and 48: DelineaAon: a mulAmodality procedur
Page 49 and 50: What does FDG PET not show ? Volume
Page 51 and 52: PET for GTV GTV involves all known
Page 53 and 54: Impact on volumes Method ! GTV 40 5
Page 55 and 56: A visual mulAmodality approach x !
Page 57 and 58: Interobserver variaAon - No PET 57
Page 59 and 60: StandardizaAon of delineaAon ! Deli
Page 61 and 62: PET for Boost definiAon A boost fie
Page 63 and 64: Day-‐to-‐day problems Facto
Page 65 and 66: Moving from tumor contouring to bio
Page 67 and 68: From where to what The Roman Dodeca
Page 69 and 70: FDG uptake predicts RT outcome [18F
Page 71 and 72: A different place for PET of nodes
Page 73 and 74: A different place for PET of nodes
Page 75 and 76:
PotenAal impact ! Less opera3ons ne
Page 78 and 79:
PET for imaging of the delivered RT
Page 80 and 81:
External beam radiotherapy ! Looks
Page 82:
Uncertain proton range ! Proton dep
Page 85 and 86:
In-‐line PET images Image quali
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PET/CT for radiotherapy planning of head-Ã¢ÂÂneck cancer

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PET/CT for radiotherapy planning of head-Ã¢ÂÂneck cancer