Joint EANM/SNMMI/ESTRO practice recommendations for the use of 2-[18F]FDG PET/CT external beam radiation treatment planning in lung cancer V1.0

Eur J Nucl Med Mol Imaging. 2022 Mar;49(4):1386-1406. doi: 10.1007/s00259-021-05624-5. Epub 2022 Jan 13.

Abstract

Purpose: 2-[18F]FDG PET/CT is of utmost importance for radiation treatment (RT) planning and response monitoring in lung cancer patients, in both non-small and small cell lung cancer (NSCLC and SCLC). This topic has been addressed in guidelines composed by experts within the field of radiation oncology. However, up to present, there is no procedural guideline on this subject, with involvement of the nuclear medicine societies.

Methods: A literature review was performed, followed by a discussion between a multidisciplinary team of experts in the different fields involved in the RT planning of lung cancer, in order to guide clinical management. The project was led by experts of the two nuclear medicine societies (EANM and SNMMI) and radiation oncology (ESTRO).

Results and conclusion: This guideline results from a joint and dynamic collaboration between the relevant disciplines for this topic. It provides a worldwide, state of the art, and multidisciplinary guide to 2-[18F]FDG PET/CT RT planning in NSCLC and SCLC. These practical recommendations describe applicable updates for existing clinical practices, highlight potential flaws, and provide solutions to overcome these as well. Finally, the recent developments considered for future application are also reviewed.

Keywords: CT; ESTRO, 2-[18F]FDG PET; Lung cancer; Planning; Radiation therapy; Radiotherapy, EANM; SNMMI.

Publication types

  • Review

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung* / radiotherapy
  • Fluorodeoxyglucose F18
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / radiotherapy
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography / methods

Substances

  • Fluorodeoxyglucose F18