Radiotherapy planning and molecular imaging in lung cancer

Angelina Filice, Massimiliano Casali, Patrizia Ciammella, Marco Galaverni, Federica Fioroni, Cinzia Iotti, Annibale Versari

Research output: Contribution to journalReview articlepeer-review


Introduction: In patients suitable for radical chemoradiotherapy for lung cancer,18F-FDG-PET/CT is a proposed management to improve the accuracy of high dose radiotherapy. However, there is a high rate of locoregional failure in patients with locally advanced non-small cell lung cancer (NSCLC), probably due to the fact that standard dosing may not be effective in all patients. The aim of the present review was to address some criticisms associated with the radiotherapy image-guided in NSCLC. Materials and Methods: A systematic literature search was conducted. Only published articles that met the following criteria were included: articles, only original papers, radiopharmaceutical ([18F]FDG and any tracer other than [18F]FDG), target, only specific for lung cancer radiotherapy planning, and experimental design (eventually “in vitro” studies were excluded). Peer-reviewed indexed journals, re-gardless of publication status (published, ahead of print, in press, etc.) were included. Reviews, case reports, abstracts, editorials, poster presentations, and publications in languages other than English were excluded. The decision to include or exclude an article was made by consensus and any dis-agreement was resolved through discussion. Results: Hundred eligible full-text articles were assessed. Diverse information is now available in the literature about the role of FDG and new alternative radiopharmaceuticals for the planning of radiotherapy in NSCLC. In particular, the role of alternative technologies for the segmentation of FDG uptake is essential, although indeterminate for RT planning. The pros and cons of the available techniques have been extensively reported. Conclusion: PET/CT has a central place in the planning of radiotherapy for lung cancer and, in par-ticular, for NSCLC assuming a substantial role in the delineation of tumor volume. The development of new radiopharmaceuticals can help overcome the problems related to the disadvantage of FDG to ac-cumulate also in activated inflammatory cells, thus improving tumor characterization and providing new prognostic biomarkers.

Original languageEnglish
Pages (from-to)204-217
Number of pages14
JournalCurrent Radiopharmaceuticals
Issue number3
Publication statusPublished - 2020


  • Lung cancer
  • Motion artifacts
  • New radiopharmaceuticals
  • Radiotherapy planning
  • Target volume definition

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pharmacology


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