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A Journal on Nuclear Medicine and Molecular Imaging

A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2017 Nov 28

DOI: 10.23736/S1824-4785.17.03033-3


language: English

How to use PET/CT in the evaluation of response to radiotherapy

Pierre DECAZES 1 , Sébastien THUREAU 2, Bernard DUBRAY 2, 3, Pierre VERA 1, 3

1 Nuclear Medicine Department, Henri Becquerel Cancer Center, Rouen, France; 2 Department of Radiation Oncology and Medical Physics, Henri Becquerel Center, Rouen, France; 3 LITIS Quantif-EA4108, University of Rouen, Rouen, France


INTRODUCTION: Radiotherapy is a major treatment modality for many cancers. Tumor response after radiotherapy determines the subsequent steps of the patient’s management (surveillance, adjuvant or salvage treatment and palliative care). Tumor response assessed during radiotherapy offers a promising opportunity to adapt the treatment plan to reduced / increased target volume, to specifically target sub-volumes with relevant biological characteristics (metabolism, hypoxia, proliferation ...) and to further spare the organs at risk. In addition to its role in the diagnosis and the initial staging, Positron Emission Tomography combined with a Computed Tomography (PET/CT) provides functional information and is therefore attractive to evaluate tumor response.
OBJECTIVE: To review the published data addressing PET/CT as an evaluation tool in irradiated tumors.
MATERIALS AND METHODS: Reports on PET/CT acquired at various times (during radiotherapy, after initial (chemo-)radiotherapy, after definitive radiotherapy and during posttreatment follow-up) in solid tumors (lung, head-and-neck, cervix, esophagus, prostate and rectum) were collected and reviewed. Various tracers and technical are also discussed.
RESULTS: 18F-FDG PET/CT has a well-established role in clinical routine after definitive chemo-radiotherapy for locally advanced head-and-neck cancers. 18F-choline PET/CT is indicated in prostate cancer patients with biochemical failure. 18F-FDG PET/CT is optional in many others circumstances and the clinical benefits of assessing tumor response with PET/CT remain a field of very active research. The combination of PET with Magnetic Resonance Imaging (PET/MRI) may prove to be valuable in irradiated rectal and cervix cancers.
CONCLUSIONS: Tumor response can be evaluated by PET/CT with clinical consequences in multiple situations, notably in head and neck and prostate cancers, after radiotherapy. Further clinical evaluation for most cancers is still needed, possibly in association to MRI.

KEY WORDS: Radiotherapy - Positron emission tomography - Treatment outcome - Follow-up

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Publication History

Article first published online: November 28, 2017
Manuscript accepted: November 23, 2017
Manuscript revised: November 20, 2017
Manuscript received: September 25, 2017

Cite this article as

Decazes P, Thureau S, Dubray B, Vera P. How to use PET/CT in the evaluation of response to radiotherapy. Q J Nucl Med Mol Imaging 2017 Nov 28. DOI: 10.23736/S1824-4785.17.03033-3

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