open access

Vol 15, Supp. C (2012)
Published online: 2013-02-19
Submitted: 2013-02-25
Accepted: 2013-02-25
Get Citation

Radiotherapy treatment planning based on functional PET/CT imaging data

Daniela Thorwarth

open access

Vol 15, Supp. C (2012)
Published online: 2013-02-19
Submitted: 2013-02-25
Accepted: 2013-02-25

Abstract

Modern radiotherapy (RT) techniques allow a highly precise
and flexible deposition of the radiation dose in the tumor. As
a consequence, high conformal tumor doses can be reached
while sparing critical organs at risk. Hence, it seems to be very
beneficial to increase the dose in the tumor according to functional
and molecular information assessed by combined PET/CT
imaging. Such functional image guided dose escalation is called
dose painting. Two different dose painting approaches have
been described to date: dose painting by contours (DPC) and
dose painting by numbers (DPBN). DPC consists of delineating
an additional functional target volume on the PET/CT images
and prescribing this volume homogeneously to a higher dose,
whereas DPBN integrates the functional image information
directly into the treatment planning process in order to shape
the dose in a locally varying manner according to the PET
information.
Before dose painting strategies can be applied routinely in
clinical practice, a number of factors that potentially affect the
accuracy and effectiveness of dose painting, such as image
acquisition and reconstruction protocols as well as image quantification
will have to be investigated in the future. Nevertheless,
integration of functional PET/CT imaging seems to be the cornerstone
for advancing RT towards personalized patient-based
treatment approaches.

Abstract

Modern radiotherapy (RT) techniques allow a highly precise
and flexible deposition of the radiation dose in the tumor. As
a consequence, high conformal tumor doses can be reached
while sparing critical organs at risk. Hence, it seems to be very
beneficial to increase the dose in the tumor according to functional
and molecular information assessed by combined PET/CT
imaging. Such functional image guided dose escalation is called
dose painting. Two different dose painting approaches have
been described to date: dose painting by contours (DPC) and
dose painting by numbers (DPBN). DPC consists of delineating
an additional functional target volume on the PET/CT images
and prescribing this volume homogeneously to a higher dose,
whereas DPBN integrates the functional image information
directly into the treatment planning process in order to shape
the dose in a locally varying manner according to the PET
information.
Before dose painting strategies can be applied routinely in
clinical practice, a number of factors that potentially affect the
accuracy and effectiveness of dose painting, such as image
acquisition and reconstruction protocols as well as image quantification
will have to be investigated in the future. Nevertheless,
integration of functional PET/CT imaging seems to be the cornerstone
for advancing RT towards personalized patient-based
treatment approaches.
Get Citation

Keywords

PET/CT, radiotherapy, segmentation, dose painting, personalized treatment

About this article
Title

Radiotherapy treatment planning based on functional PET/CT imaging data

Journal

Nuclear Medicine Review

Issue

Vol 15, Supp. C (2012)

Pages

43-47

Published online

2013-02-19

Keywords

PET/CT
radiotherapy
segmentation
dose painting
personalized treatment

Authors

Daniela Thorwarth

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