dose planning in stereotactic radiotherapy of liver tumors using 18-fluorodeoxygalactose and...
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7/28/2019 DOSE PLANNING IN STEREOTACTIC RADIOTHERAPY OF LIVER TUMORS USING 18-FLUORODEOXYGALACTOSE AND P
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ID: 168Main category: ExtracranialMain secondary category: ClinicalTopics: Dose planning, Imaging, Liver, Metastasis,Type of presentation:I am willing to do an oral sessionI am willing to do a poster session
TITLE
DOSE PLANNING IN STEREOTACTIC RADIOTHERAPY OF LIVER TUMORS USING 18-FLUORODEOXYGALACTOSE AND PET/CT-SCANNING
DESCRIPTION
Objectives: Dose planning constraints in stereotactic body radiation therapy (SBRT) of liver tumors is primarily based on liver volume after exclusion of
the clinical target volume (CTV) estimated by CT-scanning. We have developed a method where the dose planning process takes metabolic liver
function rather than volume into consideration.
Methods: The present method is based on the carbohydrate galactose which is metabolized primarily in the liver and PET/CT-scanning. 120 minutes
prior to PET/CT, a bolus of 18fluorodeoxygalactose (18FDGal) is administrated as an intravenous bolus injection. Hepatic uptake and net metabolic
clearance, K are quantified from time changes in 18FDGal-activity during dynamic scanning in 40 minutes. Conventional contrast enhanced
CT-scanning is acquired simultaneously. Results from PET/CT are compared to galactose elimination capacity as a measure of global liver function.
Results: The 18FDGal PET/CT procedure was developed in a pig model and has now been tested in 12 patients with a variety of liver diseases
inclusive liver tumors of whom 5 patients had cirrhosis of the liver. Preliminary results show positive correlation between function and FDGal uptake.18FDGal PET/CT-scanning is now being tested as a dose planning procedure in patients undergoing SBRT for liver tumors.
Conclusion and perspectives: Preliminary results show that dose planning for SBRT based on 18FDGal PET/CT scanning in patients with liver tumors
is feasible. Dose planning for radiotherapy in general and for SBRT in particular may in the future be based on combined physiological and anatomical
imaging rather than anatomical imaging alone.
Key refs:
1. Srensen-M et al.: Hepatic uptake and metabolism of galactose can be quantified in vivo by 2-[18F]fluoro-2-deoxygalactose positron emission
tomography. Am J Physiol Gastrointest Liver Physiol 295: G27G36, 2008.
2. Hyer-M et al.: Phase II study on stereotactic body radiotherapy of colorectal metastases. Acta Oncol 45: 823-830, 2007