Use of PET and PET/CT for Radiation Therapy Planning: IAEA expert report 2006-2007

Michael MacManus, Ursula Nestle, Kenneth E. Rosenzweig, Ignasi Carrio, Cristina Messa, Otakar Belohlavek, Massimo Danna, Tomio Inoue, Elizabeth Deniaud-Alexandre, Stefano Schipani, Naoyuki Watanabe, Maurizio Dondi, Branislav Jeremic

Research output: Contribution to journalReview articlepeer-review

313 Scopus citations


Positron Emission Tomography (PET) is a significant advance in cancer imaging with great potential for optimizing radiation therapy (RT) treatment planning and thereby improving outcomes for patients. The use of PET and PET/CT in RT planning was reviewed by an international panel. The International Atomic Energy Agency (IAEA) organized two synchronized and overlapping consultants' meetings with experts from different regions of the world in Vienna in July 2006. Nine experts and three IAEA staff evaluated the available data on the use of PET in RT planning, and considered practical methods for integrating it into routine practice. For RT planning, 18F fluorodeoxyglucose (FDG) was the most valuable pharmaceutical. Numerous studies supported the routine use of FDG-PET for RT target volume determination in non-small cell lung cancer (NSCLC). There was also evidence for utility of PET in head and neck cancers, lymphoma and in esophageal cancers, with promising preliminary data in many other cancers. The best available approach employs integrated PET/CT images, acquired on a dual scanner in the radiotherapy treatment position after administration of tracer according to a standardized protocol, with careful optimization of images within the RT planning system and carefully considered rules for contouring tumor volumes. PET scans that are not recent or were acquired without proper patient positioning should be repeated for RT planning. PET will play an increasing valuable role in RT planning for a wide range of cancers. When requesting PET scans, physicians should be aware of their potential role in RT planning.

Original languageEnglish
Pages (from-to)85-94
Number of pages10
JournalRadiotherapy and Oncology
Issue number1
StatePublished - Apr 2009
Externally publishedYes


  • Chemotherapy
  • Computed tomography
  • Positron Emission Tomography
  • Radiation therapy
  • Treatment planning


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