Feasibility of biology-guided radiotherapy for metastatic renal cell carcinoma driven by PSMA PET imaging
Background: Biology-guided radiotherapy (BgRT) is a novel treatment where the detection of positron emission originating from a volume called the biological tracking zone (BTZ) initiates dose delivery. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is a novel imaging te...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630823000332 |
| _version_ | 1797838596545183744 |
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| author | Mathieu Gaudreault David Chang Nicholas Hardcastle Lachlan McIntosh Price Jackson Tomas Kron Cristian Udovicich Michael S. Hofman Shankar Siva |
| author_facet | Mathieu Gaudreault David Chang Nicholas Hardcastle Lachlan McIntosh Price Jackson Tomas Kron Cristian Udovicich Michael S. Hofman Shankar Siva |
| author_sort | Mathieu Gaudreault |
| collection | DOAJ |
| description | Background: Biology-guided radiotherapy (BgRT) is a novel treatment where the detection of positron emission originating from a volume called the biological tracking zone (BTZ) initiates dose delivery. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is a novel imaging technique that may improve patient selection for metastasis-directed therapy in renal cell carcinoma (RCC). This study aims to determine the feasibility of BgRT treatment for RCC. Material and methods: All consecutive patients that underwent PSMA PET/CT scan for RCC staging at our institution between 2014 and 2020 were retrospectively considered for inclusion. GTVs were contoured on the CT component of the PET/CT scan. The tumor-to-background ratio was quantified from the normalized standardized uptake value (nSUV), defined as the ratio between SUVmax inside the GTV and SUVmean inside the margin expansion. Tumors were classified suitable for BgRT if (1) nSUV was greater or equal to an nSUV threshold and (2) if the BTZ was free of any PET-avid region other than the tumor. Results: Out of this cohort of 83 patients, 47 had metastatic RCC and were included in this study. In total, 136 tumors were delineated, 1 to 22 tumors per patient, mostly in lung (40%). Using a margin expansion of 5 mm/10 mm/20 mm and nSUV threshold = 3, 66%/63%/41% of tumors were suitable for BgRT treatment. Uptake originating from another tumor, the kidney, or the liver was typically inside the BTZ in tumors judged unsuitable for BgRT. Conclusions: More than 60% of tumors were found to be suitable for BgRT in this cohort of patients with RCC. However, the proximity of PET-avid organs such as the liver or the kidney may affect BgRT delivery. |
| first_indexed | 2024-04-09T15:43:23Z |
| format | Article |
| id | doaj.art-b2fb777b839e4bad9996fc3bc7b73305 |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-04-09T15:43:23Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-b2fb777b839e4bad9996fc3bc7b733052023-04-27T06:06:27ZengElsevierClinical and Translational Radiation Oncology2405-63082023-05-0140100608Feasibility of biology-guided radiotherapy for metastatic renal cell carcinoma driven by PSMA PET imagingMathieu Gaudreault0David Chang1Nicholas Hardcastle2Lachlan McIntosh3Price Jackson4Tomas Kron5Cristian Udovicich6Michael S. Hofman7Shankar Siva8Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia; Corresponding author at: Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia.Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, AustraliaDepartment of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, AustraliaDepartment of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, AustraliaDepartment of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, AustraliaDepartment of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, AustraliaSir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, AustraliaSir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia; Molecular Imaging and Therapeutic Nuclear Medicine, Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, AustraliaSir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, AustraliaBackground: Biology-guided radiotherapy (BgRT) is a novel treatment where the detection of positron emission originating from a volume called the biological tracking zone (BTZ) initiates dose delivery. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is a novel imaging technique that may improve patient selection for metastasis-directed therapy in renal cell carcinoma (RCC). This study aims to determine the feasibility of BgRT treatment for RCC. Material and methods: All consecutive patients that underwent PSMA PET/CT scan for RCC staging at our institution between 2014 and 2020 were retrospectively considered for inclusion. GTVs were contoured on the CT component of the PET/CT scan. The tumor-to-background ratio was quantified from the normalized standardized uptake value (nSUV), defined as the ratio between SUVmax inside the GTV and SUVmean inside the margin expansion. Tumors were classified suitable for BgRT if (1) nSUV was greater or equal to an nSUV threshold and (2) if the BTZ was free of any PET-avid region other than the tumor. Results: Out of this cohort of 83 patients, 47 had metastatic RCC and were included in this study. In total, 136 tumors were delineated, 1 to 22 tumors per patient, mostly in lung (40%). Using a margin expansion of 5 mm/10 mm/20 mm and nSUV threshold = 3, 66%/63%/41% of tumors were suitable for BgRT treatment. Uptake originating from another tumor, the kidney, or the liver was typically inside the BTZ in tumors judged unsuitable for BgRT. Conclusions: More than 60% of tumors were found to be suitable for BgRT in this cohort of patients with RCC. However, the proximity of PET-avid organs such as the liver or the kidney may affect BgRT delivery.http://www.sciencedirect.com/science/article/pii/S2405630823000332BgRTPSMARCCBTZ |
| spellingShingle | Mathieu Gaudreault David Chang Nicholas Hardcastle Lachlan McIntosh Price Jackson Tomas Kron Cristian Udovicich Michael S. Hofman Shankar Siva Feasibility of biology-guided radiotherapy for metastatic renal cell carcinoma driven by PSMA PET imaging Clinical and Translational Radiation Oncology BgRT PSMA RCC BTZ |
| title | Feasibility of biology-guided radiotherapy for metastatic renal cell carcinoma driven by PSMA PET imaging |
| title_full | Feasibility of biology-guided radiotherapy for metastatic renal cell carcinoma driven by PSMA PET imaging |
| title_fullStr | Feasibility of biology-guided radiotherapy for metastatic renal cell carcinoma driven by PSMA PET imaging |
| title_full_unstemmed | Feasibility of biology-guided radiotherapy for metastatic renal cell carcinoma driven by PSMA PET imaging |
| title_short | Feasibility of biology-guided radiotherapy for metastatic renal cell carcinoma driven by PSMA PET imaging |
| title_sort | feasibility of biology guided radiotherapy for metastatic renal cell carcinoma driven by psma pet imaging |
| topic | BgRT PSMA RCC BTZ |
| url | http://www.sciencedirect.com/science/article/pii/S2405630823000332 |
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