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Use of standardized uptake value thresholding for target volume delineation in pediatric Hodgkin lymphoma  Amanda J. Walker, MD, Alin Chirindel, MD, Robert.

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Presentation on theme: "Use of standardized uptake value thresholding for target volume delineation in pediatric Hodgkin lymphoma  Amanda J. Walker, MD, Alin Chirindel, MD, Robert."— Presentation transcript:

1 Use of standardized uptake value thresholding for target volume delineation in pediatric Hodgkin lymphoma  Amanda J. Walker, MD, Alin Chirindel, MD, Robert F. Hobbs, PhD, Minh-Phuong Huynh-Le, Joseph A. Moore, PhD, Steve Y. Cho, MD, Stephanie A. Terezakis, MD  Practical Radiation Oncology  Volume 5, Issue 4, Pages (July 2015) DOI: /j.prro Copyright © 2015 American Society for Radiation Oncology Terms and Conditions

2 Figure 1 Two patients and 3 corresponding maximum standardized uptake value threshold volumes (15%, 25%, and 40%) applied to the prechemotherapy positron emission tomography scans. Practical Radiation Oncology 2015 5, DOI: ( /j.prro ) Copyright © 2015 American Society for Radiation Oncology Terms and Conditions

3 Figure 2 Involved site radiation therapy clinical target volumes (CTVs) generated based on 15% maximum standardized uptake value threshold (SUVmax), 40% (SUVmax), and qualitative visual method (ie, current standard of care; CTVQVM) represented on digitally reconstructed radiographs for 2 representative patients. Practical Radiation Oncology 2015 5, DOI: ( /j.prro ) Copyright © 2015 American Society for Radiation Oncology Terms and Conditions

4 Figure 3 Thresholding based on maximum standardized uptake value (SUVmax) led to changes in involved field radiation therapy treatment fields in 2 of 16 patients. Here is a pretreatment positron emission tomography/computed tomography scan for 1 patient, with the 15% SUVmax threshold outlined in blue and the 40% SUVmax threshold outlined in purple. With 15% SUVmax thresholding, the right cervical region was included in the treatment field (white arrow). When 20% or higher SUVmax thresholds were applied, the right cervical region was no longer included in the treatment field. Practical Radiation Oncology 2015 5, DOI: ( /j.prro ) Copyright © 2015 American Society for Radiation Oncology Terms and Conditions

5 Figure 4 Average mean dose to normal structures for involved site radiation therapy (ISRT) plans generated from 15% maximum standardized uptake value (ISRT_CTV15% and 40% maximum standardized uptake value (ISRT_CTV40%) normalized to ISRT plans generated from the qualitative visual method (ISRT_CTVQVM, ie, current standard of care). Practical Radiation Oncology 2015 5, DOI: ( /j.prro ) Copyright © 2015 American Society for Radiation Oncology Terms and Conditions

6 Figure 5 Representative involved site radiation therapy (ISRT) treatment plans generated for 3 patients based on 15% maximum (max) standardized uptake value threshold, 40% maximum standardized uptake value threshold, and the qualitative visual method (QVM, ie, manual contours) are shown. A 95% isodose line is shown in green. Bottom: heart is contoured and outlined in red. CTV, clinical target volume; PET, positron emission tomography. Practical Radiation Oncology 2015 5, DOI: ( /j.prro ) Copyright © 2015 American Society for Radiation Oncology Terms and Conditions


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