ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2026
Impact of PET/CT imaging on target volume delineation and radiotherapy planning in patients with locally advanced esophageal cancer.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
background and purposeCombined chemoradiotherapy is a key treatment strategy for esophageal cancer in both neoadjuvant and definitive settings. Accurate and consistent target volume delineation is essential to optimize therapeutic efficacy and minimize toxicity. MATERIALS AND
methodsTwenty patients treated between 2022 and 2024 at the Department of Radiation Oncology, University Hospital Magdeburg, were included. Gross tumor volumes (GTVs) were independently delineated on CT and PET/CT datasets. Clinical target volumes (CTVs) and planning target volumes (PTVs) were subsequently generated. Geometric agreement was assessed using the Dice similarity coefficient (DSC) and 95th percentile Hausdorff distance (HD95). Interobserver variability was evaluated using simultaneous truth and performance level estimation (STAPLE)-generated reference contours. Paired t‑tests (α = 0.05) were used to assess volumetric and dosimetric differences.
resultsPET/CT-based planning significantly reduced PTV volumes, with mean PTV decreasing from 602.3 ± 267.4 cm
conclusionPET/CT-guided radiotherapy planning substantially influences target volume geometry in esophageal cancer and enables identification of metabolically active disease not adequately covered by CT-based planning alone. In addition to significant target volume reduction and lower pulmonary dose exposure, PET/CT-based contouring may support more consistent target volume delineation. Prospective studies are warranted to determine whether these geometric and dosimetric advantages translate into improved oncologic outcomes and reduced treatment-related toxicity.
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