PET/CT-guided treatment planning for paediatric cancer patients: A simulation study of proton and conventional photon therapy

Josefine Ståhl Kornerup, N. P. Brodin, T. Björk-Eriksson, C. Birk Christensen, A. Kiil-Berthelsen, M. C. Aznar, C. Hollensen, E. Markova, P. Munck Af Rosenschöld

Research output: Contribution to journalArticlepeer-review


Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT-and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT.

Original languageEnglish (US)
Article number20140586
JournalBritish Journal of Radiology
Issue number1047
StatePublished - Mar 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


Dive into the research topics of 'PET/CT-guided treatment planning for paediatric cancer patients: A simulation study of proton and conventional photon therapy'. Together they form a unique fingerprint.

Cite this