Radiotherapy Planning and Molecular Imaging in Lung Cancer.
INTRODUCTION
In patients suitable for radical chemoradiotherapy for lung cancer, 18F-FDGPET/ CT is a proposed management to improve the accuracy of high dose radiotherapy. However, there is a high rate of locoregional failure in patients with locally advanced non-small cell lung cancer (NSCLC), probably due to the fact that standard dosing may not be effective in all patients. The aim of the present review was to address some criticisms associated with the radiotherapy image-guided in NSCLC.


MATERIALS AND METHODS
A systematic literature search was conducted. Only published articles that met the following criteria were included: articles, only original papers, radiopharmaceutical ([18F]FDG and any tracer other than [18F]FDG), target, only specific for lung cancer radiotherapy planning, and experimental design (eventually "in vitro" studies were excluded). Peer-reviewed indexed journals, regardless of publication status (published, ahead of print, in press, etc.) were included. Reviews, case reports, abstracts, editorials, poster presentations, and publications in languages other than English were excluded. The decision to include or exclude an article was made by consensus and any disagreement was resolved through discussion.


RESULTS
Hundred eligible full-text articles were assessed. Diverse information is now available in the literature about the role of FDG and new alternative radiopharmaceuticals for the planning of radiotherapy in NSCLC. In particular, the role of alternative technologies for the segmentation of FDG uptake is essential, although indeterminate for RT planning. The pros and cons of the available techniques have been extensively reported.


CONCLUSION
PET/CT has a central place in the planning of radiotherapy for lung cancer and, in particular, for NSCLC assuming a substantial role in the delineation of tumor volume. The development of new radiopharmaceuticals can help overcome the problems related to the disadvantage of FDG to accumulate also in activated inflammatory cells, thus improving tumor characterization and providing new prognostic biomarkers.
['Filice|Angelina|A|', 'Casali|Massimiliano|M|', 'Ciammella|Patrizia|P|', 'Galaverni|Marco|M|', 'Fioroni|Federica|F|', 'Iotti|Cinzia|C|', 'Versari|Annibale|A|']
D002289:Carcinoma, Non-Small-Cell Lung D019788:Fluorodeoxyglucose F18 D006801:Humans D008175:Lung Neoplasms D057054:Molecular Imaging D000072078:Positron Emission Tomography Computed Tomography D019275:Radiopharmaceuticals D011880:Radiotherapy Planning, Computer-Assisted
Radiotherapy planning lung cancer new radiopharmaceuticals 18F-FDG-PET/CT motion artifacts target volume
definition