Thorwarth D, Beyer T, Boellaard R, de Ruysscher D, Grgic A, Lee J A, Pietrzyk U, Sattler B, Schaefer A, van Elmpt W, Vogel W, Oyen W J G, Nestle U
University Hospital for Radiation Oncology, Section for Biomedical Physics, Eberhard-Karls University Tübingen, Germany.
Nuklearmedizin. 2012;51(4):140-53. doi: 10.3413/Nukmed-0455-11-12. Epub 2012 Apr 3.
This work addresses the clinical adoption of FDG-PET/CT for image-guided radiation therapy planning (RTP). As such, important technical and methodological aspects of PET/CT-based RTP are reviewed and practical recommendations are given for routine patient management and clinical studies. First, recent developments in PET/CT hardware that are relevant to RTP are reviewed in the context of quality control and system calibration procedures that are mandatory for a reproducible adoption of PET/CT in RTP. Second, recommendations are provided on image acquisition and reconstruction to support the standardization of imaging protocols. A major prerequisite for routine RTP is a complete and secure data transfer to the actual planning system. Third, state-of-the-art tools for image fusion and co-registration are discussed briefly in the context of PET/CT imaging pre- and post-RTP. This includes a brief review of state-of-the-art image contouring algorithms relevant to PET/CT-guided RTP. Finally, practical aspects of clinical workflow and patient management, such as patient setup and requirements for staff training are emphasized. PET/CT-guided RTP mandates attention to logistical aspects, patient set-up and acquisition parameters as well as an in-depth appreciation of quality control and protocol standardization.
Upon fulfilling the requirements to perform PET/CT for RTP, a new dimension of molecular imaging can be added to traditional morphological imaging. As a consequence, PET/CT imaging will support improved RTP and better patient care. This document serves as a guidance on practical and clinically validated instructions that are deemed useful to the staff involved in PET/CT-guided RTP.
本研究探讨了18F-FDG-PET/CT在图像引导放射治疗计划（RTP）中的临床应用。因此，本文回顾了基于PET/CT的RTP的重要技术和方法学方面，并针对常规患者管理和临床研究给出了实用建议。首先，在质量控制和系统校准程序的背景下，回顾了与RTP相关的PET/CT硬件的最新进展，这些程序是在RTP中可重复采用PET/CT所必需的。其次，提供了关于图像采集和重建的建议，以支持成像协议的标准化。常规RTP的一个主要前提是将完整且安全的数据传输到实际的计划系统。第三，在PET/CT成像的RTP前后的背景下，简要讨论了图像融合和配准的最新工具。这包括对与PET/CT引导的RTP相关的最新图像轮廓算法的简要回顾。最后，强调了临床工作流程和患者管理的实际方面，如患者摆位和工作人员培训要求。PET/CT引导的RTP要求关注后勤方面、患者摆位和采集参数，以及对质量控制和协议标准化的深入理解。
在满足进行PET/CT用于RTP的要求后，可以在传统形态学成像中增加分子成像的新维度。因此，PET/CT成像将有助于改善RTP并提供更好的患者护理。本文档作为实用且经过临床验证的指南，对参与PET/CT引导的RTP的工作人员有用。
