FDG-PET in der Bestrahlungsplanung von nichtkleinzelligen Bronchialkarzinomen

Abstract

Besides the use of FDG-PET in staging and restaging of patients with non-small cell lung cancer (NSCLC), the integration of PET-data into the radiotherapy planning process is a promising field for PET in radiooncology. The possible benefit of the patients lies in the more exact definition of malignant structures for target volume definition. Especially in cases with post-obstructive atelectasis the use of FDG-PET significantly improves the inter-observer-variability of target volumes. Moreover, the higher diagnostic accuracy in lymph node staging compared to CT could lead to a restriction of irradiation fields to FDG positive areas, if clinical target volume concepts were adapted to the new technologies available. Still unsolved is the problem of which is the best method for technical delineation of PET-based target volumes, as due to resolution and movement effects, the FDG-accumulations appear blurred. Here, possibly contrast-oriented methods are of use. Clinical studies will show the benefit of FDG-PET based target volume definition for patients with NSCLC concerning local control and normal tissue complication probability. The aim is to apply higher radiation doses in more exactly defined volumes, while simultaneously sparing normal tissues.