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Precision Radiotherapy: (18)F-FDG PET-based radiotherapy planning in Head and Neck cancers

Precision medicine is gaining importance in this era of molecular imaging where the molecular features of a disease can be noninvasively assessed and treated with personalized medicine. This is especially suited for head and neck cancers (HNCa). Early stage HNCa are ideally managed with radiotherapy...

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Autores principales: Subramanyam, Padma, Palaniswamy, Shanmuga Sundaram, Numani, Shah Pervez
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745861/
https://www.ncbi.nlm.nih.gov/pubmed/33354173
http://dx.doi.org/10.4103/wjnm.WJNM_91_19
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author Subramanyam, Padma
Palaniswamy, Shanmuga Sundaram
Numani, Shah Pervez
author_facet Subramanyam, Padma
Palaniswamy, Shanmuga Sundaram
Numani, Shah Pervez
author_sort Subramanyam, Padma
collection PubMed
description Precision medicine is gaining importance in this era of molecular imaging where the molecular features of a disease can be noninvasively assessed and treated with personalized medicine. This is especially suited for head and neck cancers (HNCa). Early stage HNCa are ideally managed with radiotherapy (RT) or surgery. Head and neck (HN) is a complex region and its tumors respond to RT differently due to dissimilar structures and moving organs such as tongue. Radiation oncologists are always in the process of trying and investigating newer RT techniques in order to achieve precise and targetted therapy to tumour/s. One such innovation is Intensity modulated RT (IMRT) using 3 Dimensional conformal RT (3DCRT). This 3DCRT resizes the radiation beams to match the shape of the tumor. Such focused dose escalation may improve local control in HNCa. Image guided RT in conjunction with IMRT is the most advanced form of RT planning being used these days. Simulation computerized tomography (CT) images are usually incorporated into RT planning module. But limitations of CT such as poor soft tissue contrast than magnetic resonance imaging and inability to clearly define solid / cystic / necrotic areas and viable tumour exist. Functional imaging such as Positron Emission Tomography (PET) has established its superiority over CT in delineating the actual site and extent of HN tumors. A combination of IMRT with BTV (Biological Tumour Volume) may be the most ideal technique to deliver a homogeneous radiation boost to tumour. This review shall discuss PET based RT planning, challenges, practical tips, and how to optimize therapy with the least side effects to the normal surrounding tissues.
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spelling pubmed-77458612020-12-21 Precision Radiotherapy: (18)F-FDG PET-based radiotherapy planning in Head and Neck cancers Subramanyam, Padma Palaniswamy, Shanmuga Sundaram Numani, Shah Pervez World J Nucl Med Review Article Precision medicine is gaining importance in this era of molecular imaging where the molecular features of a disease can be noninvasively assessed and treated with personalized medicine. This is especially suited for head and neck cancers (HNCa). Early stage HNCa are ideally managed with radiotherapy (RT) or surgery. Head and neck (HN) is a complex region and its tumors respond to RT differently due to dissimilar structures and moving organs such as tongue. Radiation oncologists are always in the process of trying and investigating newer RT techniques in order to achieve precise and targetted therapy to tumour/s. One such innovation is Intensity modulated RT (IMRT) using 3 Dimensional conformal RT (3DCRT). This 3DCRT resizes the radiation beams to match the shape of the tumor. Such focused dose escalation may improve local control in HNCa. Image guided RT in conjunction with IMRT is the most advanced form of RT planning being used these days. Simulation computerized tomography (CT) images are usually incorporated into RT planning module. But limitations of CT such as poor soft tissue contrast than magnetic resonance imaging and inability to clearly define solid / cystic / necrotic areas and viable tumour exist. Functional imaging such as Positron Emission Tomography (PET) has established its superiority over CT in delineating the actual site and extent of HN tumors. A combination of IMRT with BTV (Biological Tumour Volume) may be the most ideal technique to deliver a homogeneous radiation boost to tumour. This review shall discuss PET based RT planning, challenges, practical tips, and how to optimize therapy with the least side effects to the normal surrounding tissues. Wolters Kluwer - Medknow 2020-08-22 /pmc/articles/PMC7745861/ /pubmed/33354173 http://dx.doi.org/10.4103/wjnm.WJNM_91_19 Text en Copyright: © 2020 World Journal of Nuclear Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Subramanyam, Padma
Palaniswamy, Shanmuga Sundaram
Numani, Shah Pervez
Precision Radiotherapy: (18)F-FDG PET-based radiotherapy planning in Head and Neck cancers
title Precision Radiotherapy: (18)F-FDG PET-based radiotherapy planning in Head and Neck cancers
title_full Precision Radiotherapy: (18)F-FDG PET-based radiotherapy planning in Head and Neck cancers
title_fullStr Precision Radiotherapy: (18)F-FDG PET-based radiotherapy planning in Head and Neck cancers
title_full_unstemmed Precision Radiotherapy: (18)F-FDG PET-based radiotherapy planning in Head and Neck cancers
title_short Precision Radiotherapy: (18)F-FDG PET-based radiotherapy planning in Head and Neck cancers
title_sort precision radiotherapy: (18)f-fdg pet-based radiotherapy planning in head and neck cancers
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745861/
https://www.ncbi.nlm.nih.gov/pubmed/33354173
http://dx.doi.org/10.4103/wjnm.WJNM_91_19
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