Combined 18F-FDG-PET/CT Imaging in Radiotherapy Target Delineation for Head-and-Neck Cancer

Alessandra Guido, Lorenzo Fuccio, Barbara Rombi, Paolo Castellucci, Agnese Cecconi, Feisal Bunkheila, Chiara Fuccio, Emiliano Spezi, Anna Lisa Angelini, Enza Barbieri

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate the effect of the use of 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in radiotherapy target delineation for head-and-neck cancer compared with CT alone. Methods and Materials: A total of 38 consecutive patients with head-and-neck cancer were included in this study. The primary tumor sites were as follow: 20 oropharyngeal tumors, 4 laryngeal tumors, 2 hypopharyngeal tumors, 2 paranasal sinuses tumors, 9 nasopharyngeal tumors, and 1 parotid gland tumor. The FDG-PET and CT scans were performed with a dedicated PET/CT scanner in one session and then fused. Subsequently, patients underwent treatment planning CT with intravenous contrast enhancement. The radiation oncologist defined all gross tumor volumes (GTVs) using both the PET/CT and CT scans. Results: In 35 (92%) of 38 cases, the CT-based GTVs were larger than the PET/CT-based GTVs. The average total GTV from the CT and PET/CT scans was 34.54 cm3 (range, 3.56-109) and 29.38 cm3 (range, 2.87-95.02), respectively (p <0.05). Separate analyses of the difference between the CT- and PET/CT-based GTVs of the primary tumor compared with the GTVs of nodal disease were not statistically significant. The comparison between the PET/CT-based and CT-based boost planning target volumes did not show a statistically significant difference. All patients were alive at the end of the follow-up period (range, 3-38 months). Conclusion: GTVs, but not planning target volumes, were significantly changed by the implementation of combined PET/CT. Large multicenter studies are needed to ascertain whether combined PET/CT in target delineation can influence the main clinical outcomes.

Original languageEnglish
Pages (from-to)759-763
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number3
Publication statusPublished - Mar 1 2009


  • F-fluorodeoxyglucose-positron emission tomography
  • Computed tomography
  • Gross tumor volume
  • GTV
  • Head-and-neck cancer
  • Image fusion
  • PET-CT
  • Planning target volume
  • PTV

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research


Dive into the research topics of 'Combined 18F-FDG-PET/CT Imaging in Radiotherapy Target Delineation for Head-and-Neck Cancer'. Together they form a unique fingerprint.

Cite this