心脑血管药理、食管癌放疗增敏研究biologicalimageguidedrt-gregiore.pptVIP

* In order to be able to sum the different dose maps, we’ll have to deform those dose maps by applying the deformation maps on the dose maps. If we summate all the deformed dose maps with the reference prêt dose maps, we will be able to evaluate the real dose received by the patient Metabolism: 18F-FDG 11C-Met Proliferation: 76Br-BFU Image-Guided Radiation Therapy in HNSCC What could we dream of … Hypoxia: 18F-EF3 A: dayx (before treatment) B: dayx+3 (before treatment) F-Miso PET-CT Zhixiong, Ling et al., 2008 How frequently? … Image-Guided Radiation Therapy in HNSCC Change in TV selection depends on the sensitivity and the specificity of FDG-PET compared to conventional methods. Change in TV selection is thus highly tumor-site dependent. Providing that a strict methodology is used, FDG-PET GTV might be closer to the “ground truth” for HNSCC. Use of FDG-PET during RxTh needs further validation. Biological IGRT based on new PET tracers should remain in the research arena. Take home message * Functional imaging and radiobiology Vincent GREGOIRE, M.D., Ph.D., Hon. FRCR Head and Neck Oncology Program, Radiation Oncology Dept., Center for Molecular Imaging and Experimental Radiotherapy, Université Catholique de Louvain, St-Luc University Hospital, Brussels, Belgium S / RxTh / CH Work-up-staging prognostic evaluation GTV/CTV Selection/delineation Final response evaluation Early response evaluation Functional Image-guided IMRT Early detection of recurrence FDG C-methionine EF3 - F-miso - CuATSM BFU - FLT … Potential added-value of PET in oncology The use of FDG-PET for the selection of Target Volume: setting the scene Q: unilateral vs bilateral neck irradiation? A: highly sensitive examination Laryngeal SCC: T2-N1-M0 Detection of metastatic disease in the neck Kyzas et al., JNCI 2008 Meta-analysis: n= 1236 patients (32 studies) HNSCC (all sites) Neck dissection for all patients PET-FDG - N stage in NSCLC Detection of N2-N3 in NSCLC Poncelet et al. Eur J Car