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British Journal of Radiology (2005) Supplement_28, 50-54
© 2005 British Institute of Radiology
doi: 10.1259/bjr/83746792
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The potential of PET to increase understanding of the biological basis of tumour and normal tissue response to radiotherapy

C M L West, PhD1 and N Charnley, FRCR2

1 Academic Department of Radiation Oncology, The University of Manchester, Christie Hospital NHS Trust, Wilmslow Road, Withington, Manchester M20 4BX and 2 Wolfson Molecular Imaging Centre, The University of Manchester, Christie Hospital, 27 Palatine Road, Manchester M20 3LJ, UK



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  		Figure 1. Theoretical image of radiotherapy planning volumes incorporating a PET-defined biological target volume (BTV) for dose escalation. GTV, gross tumour volume defined using high spatial resolution CT or MRI; CTV, clinical target volume defined by a clinician to account for microscopic tumour spread; PTV, planning target volume defined by a physicist to incorporate margins allowing for tumour motion and set-up errors; NTI, normal tissue; NTII, normal tissue at increased risk of radiation damage defined by molecular imaging. Careful planning of the 40% isodose (ISO) line to exclude NTII enables the delivery of a reduced dose to the high-risk area.

 


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  		Figure 2. Fused PET and CT image of a patient with oropharyngeal carcinoma, where 64Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) (60Cu-ATSM) is used as the hypoxia tracer. The image illustrates regions of heterogeneous 60Cu-ATSM intensity within the gross tumour, representing the presence of tumour hypoxia. Reproduced with kind permission from: Chao KS, Bosch WR, Mutic S, et al. A novel approach to overcome hypoxic tumor resistance: Cu-ATSM-guided intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys 2001;49:1171–82.

 


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  		Figure 3. A gross tumour volume on CT scan in a patient with oropharyngeal carcinoma, and biological target volume on the corresponding 64Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) (60Cu-ATSM) image. Reproduced with kind permission from: Chao KS, Bosch WR, Mutic S, et al. A novel approach to overcome hypoxic tumor resistance: Cu-ATSM-guided intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys 2001;49:1171–82.

 




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