The role of amino acid PET in radiotherapy target volume delineation for adult-type diffuse gliomas: A review of the literature

Patrick J Horsley; Dale L Bailey; Geoffrey Schembri; Edward Hsiao; James Drummond; Michael F Back

doi:10.1016/j.critrevonc.2024.104552

The role of amino acid PET in radiotherapy target volume delineation for adult-type diffuse gliomas: A review of the literature

Crit Rev Oncol Hematol. 2024 Nov 8:205:104552. doi: 10.1016/j.critrevonc.2024.104552. Online ahead of print.

Authors

Patrick J Horsley¹, Dale L Bailey², Geoffrey Schembri³, Edward Hsiao³, James Drummond⁴, Michael F Back⁵

Affiliations

¹ Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia. Electronic address: Patrick.Horsley@health.nsw.gov.au.
² Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
³ Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
⁴ Department of Radiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
⁵ Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, New South Wales, Australia; The Brain Cancer Group, Sydney, New South Wales, Australia; Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Central Coast Cancer Centre, Gosford Hospital, Gosford, New South Wales, Australia.

PMID: 39521308
DOI: 10.1016/j.critrevonc.2024.104552

Abstract

Purpose: To summarise existing literature examining amino acid positron emission tomography (AA-PET) for radiotherapy target volume delineation in patients with gliomas.

Methods: Systematic search of MEDLINE and EMBASE databases.

Results: Twenty studies met inclusion criteria. Studies comparing MRI- and AA-PET- derived target volumes consistently found these to be complementary. Across studies, AA-PET was a strong predictor of the site of subsequent relapse. In studies examining AA-PET-guided radiotherapy at standard doses, including one study using reduced margins, survival outcomes were similar to historical cohorts whose volumes were generated using MRI alone. Four prospective single-arm trials examining AA-PET-guided dose-escalated radiotherapy reported mixed results. The two trials that used both a higher biologically-effective dose and boost-volumes defined using both MRI and AA-PET reported promising outcomes.

Conclusion: AA-PET is a promising complementary tool to MRI for radiotherapy target volume delineation, with potential benefits requiring further validation including margin reduction and facilitation of dose-escalation.

Keywords: Amino acid PET; Glioblastoma; Glioma; Radiation therapy.

Publication types

Review