2-Deoxy-2-[ 18F]Fluoro-D-Glucose Positron Emission Tomography in Target Volume Definition for Radiotherapy of Patients with Non-Small-Cell Lung Cancer

Abstract

Purpose: To discuss the potential contribution of 2-deoxy-2-[ 18F]fluoro-D-glucose positron emission tomography (FDG-PET) in radiotherapy planning for non-small-cell lung cancer (NSCLC) considering new concepts on target volume definition. Procedures: Recent investigations on the topic are reviewed with regard to current concepts of target volume definition for NSCLC. Results: As intrathoracic recurrence is the leading cause of death after primary radiotherapy of NSCLC, there is a need for improving local control by escalating treatment intensity to gross disease. The value of elective nodal irradiation (ENI), resembling prophylactic irradiation of macroscopically unaffected parts of the mediastinum, is being considered. Conclusion: As FDG-PET has been shown to enhance the diagnostic accuracy of computed tomography (CT), and to have a potentially high impact on the identification of malignant tissue, it should be implicated in prospective clinical trials on dose escalation and three-dimensional conformal radiotherapy, especially in those including a reduction of target volumes. (Mol Imag Biol 2002;4:257–263)