Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 6)
PET/CT fusion in radiotherapy planning for lung cancer – Case reports
Authors:
Marko Dj Erak*†, Milana Mitrić†, Branislav Djuran*†, Dušanka Tešanović†, Sanja Vasiljev†
Introduction. Application of imaging methods, namely computedtomography (CT), magnetic resonance imaging (MRI) and in recent
years positron emission tomography/computed tomography
(PET/CT), and the progress of computer technology have allowed
the construction of effective computed systems for treatment
planning (TPS) and introducing the concept of virtual simulation
in 3D conformal radiotherapy planning. Case report. We hereby
presented two patients with the diagnosis of non-small cell lung
cancer who did PET/CT examination. Both patients had surgery
earlier and local recidives are diagnosed with PET/CT. PET/CT
of the first patient described the focus of intense 18Ffluorodeoxyglucose
(18FDG) accumulation 2.99 × 2.9 × 2.1cm in
diameter in the projection of soft-tissue volume in the left corner,
at operating clips height, corresponding to metabolically active recurrence
of the tumor. Mediastinum and right lung parenchyma
were without focal accumulation of 18FDG. Control PET/CT after
3 months was without detectable focus of intense pathological
18FDG accumulation – good therapeutic response, (metabolic disease
remission). On the other hand, in the second case PET/CT
showed a focus of intense 18FDG accumulation screening in the
scar tissue of the apical part of the right lung, 20 × 16 mm, corresponding
to metabolically active tumor recurrence. In the lung parenchyma
on the left and in the mediastinum no visible focus of
intense 18FDG accumulation was descrbed. Radiography included
using 3D conformal radiotherapy with fusion PET/CT scan and
CT simulations. Conclusion. PET/CT provides important information
for planning conformal radiotherapy, especially in dose escalation,
sparing of organ at risk and better locoregional control of
the disease.
