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ORIGINAL ARTICLE
Year : 2012  |  Volume : 27  |  Issue : 2  |  Page : 95-100

A quantitative comparison of gross tumour volumes delineated on [18F]-FDG PET-CT scan and CECT scan in head and neck cancers


1 Department of Radiation, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
2 Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
3 Department of Medical Physics, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
4 Department of Radiology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Correspondence Address:
G Venkada Manickam
Rajiv Gandhi Cancer Institute and Research Centre, Sec 5, Rohini, New Delhi - 110 085
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.110691

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Purpose: To compare quantitatively Gross tumor volume (GTV), both primary and nodal areas of head and neck cancers, delineated on [18F]-2fluoro, 2deoxy d-glucose-positron emission tomography/computed tomography ([18F]-FDG-PET-CT) scan to those delineated on Contrast-enhanced CT scan (CECT scan). Methods: A total of 26 consecutive patients with squamous cell cancers of head and neck were included in this study. The primary sites were oropharynx ( n = 7), hypopharynx ( n = 6), paranasal sinus ( n = 6), nasopharynx ( n = 4), oral cavity ( n = 2), and one with unknown primary and secondary neck node. All patients underwent routine staging work-up. FDG-PET and CECT scans were performed with dedicated PET-CT scanner in single session as a part of the radiotherapy treatment planning for Intensity modulated radiotherapy/Image-guided radiotherapy. Results: All patients had abnormal increased uptake in PET-CT scans. PET-CT resulted in changes of CT-based staging in 8 of 26 patients (up-staged in 7 and down-staged in 1). The mean primary and nodal GTV volumes on PET-CT and CT were significantly different (primary: PET-GTV: 48.43 ± 53.21 cc vs. CT 54.78 ± 64.47 cc, P < 0.001; nodes: PET-GTV: 12.72 ± 15.46 cc vs. 11.04 ± 14.87 cc, P < 0.001). The mismatch between two target volumes was statistically significant ( P = 0.03 for GTV primary, P = 0.04 for GTV node). Conclusion: Accuracy of delineation of GTV can be improved along with functional imaging using [18F]-FDG. These metabolically active volumes are significantly smaller than CT-based volumes and could be missed during conventional CT-based target delineations of GTVs.


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