Fiducial markers coupled with 3D PET/CT offer more accurate radiation treatment delivery for locally advanced esophageal cancer.

摘要: Background and aims The role of three-dimensional positron emission tomography/computed tomography (3 D PET/CT) in esophageal tumors that move with respiration have potential for significant mucosal inflammation is unclear. The aim this study was to determine the correlation between gross tumor volumes derived from 3 D PET/CT endoscopically placed fiducial markers. Methods This a retrospective, IRB approved analysis 40 patients cancer fiducials implanted PET/CT. centroid each identified on images. Distance volume measured using axial slices. Image features were extracted tested pathologic response predictability. Results The median adaptively calculated threshold value standardized uptake (SUV) define metabolic (MTV) border 2.50, which corresponded 23 % maximum SUV. distance inferior MTV – 0.60 cm (– 3.9 2.7 cm). superior 1.25 cm (– 4.2 6.9 cm). There no MTV-to-fiducial distances greater than 2 cm gastroenterologist who performed implantation. Eccentricity demonstrated statistically correlations response. Conclusions There stronger location compared extent. etiology discordance superiorly unclear, potentially representing benign secondary esophagitis, presence malignant nodes, caused by technical aspects placement itself, or submucosal disease. Given concordance inferiorly ability more precisely set up patient daily image guidance matching fiducials, it may be possible minimize planning (PTV) margin select patients, thereby, limiting dose normal structures.