Exploring the impact of metabolic imaging in head and neck cancer treatment
Diana Raquel Dias Domingues1,2, Michelle M Leech2
1Cambridge University Hospitals NHS Trust, Cambridge, UK.
Background:
Target volume delineation is performed with anatomical imaging for head and neck cancer. Molecular imaging allows the recognition of specific tumor regions. Its inclusion in the pathway could lead to changes in delineation and resultant treatment plans.
Methods:
PRISMA methodology was adhered to when selecting the articles for analysis and only full articles were quality assessed.
Results:
Seventeen articles were included. Gross tumor volume (GTV) primary, GTV nodal, and other target volumes were evaluated. Positron emission tomography/computerized tomography (PET/CT) produced smaller primary GTVs, although not with diffusion-weighted imaging-magnetic resonance imaging (DWI-MRI) or PET/MRI. The impact of these image modalities on GTV nodal did not display any consistency. Additionally, there was considerable heterogeneity in metrics comparing delineations. Four studies included appraised the dosimetric impact of the changes in target volume delineation.
Conclusion:
Quantifying the impact of molecular imaging is difficult, due to heterogeneity in reporting metrics in molecular imaging modalities and a paucity of detail regarding delineation method and guideline adherence.
Insights
Molecular imaging can identify specific tumor regions in head and neck cancer, potentially altering treatment plans. However, its impact on target volume delineation varies, making quantification challenging.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Anatomical imaging is standard for head and neck cancer target volume delineation.
- Molecular imaging offers recognition of specific tumor regions, potentially impacting delineation and treatment.
Purpose of the Study:
- To review the impact of molecular imaging on target volume delineation in head and neck cancer.
- To assess changes in gross tumor volume (GTV) and their dosimetric consequences.
Main Methods:
- Systematic review adhering to PRISMA methodology.
- Inclusion of 17 full articles for quality assessment and analysis.
Main Results:
- Positron emission tomography/computerized tomography (PET/CT) resulted in smaller primary GTVs compared to other modalities.
- Inconsistent impact of molecular imaging on GTV nodal and considerable heterogeneity in delineation metrics.
- Four studies evaluated the dosimetric impact of target volume changes.
Conclusions:
- Quantifying molecular imaging's impact is challenging due to heterogeneous reporting and lack of detail on delineation methods.
- Further standardization is needed to fully understand and utilize molecular imaging in radiotherapy planning.
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