Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Based Clinical Target Volume Delineation Guideline for Postprostatectomy Salvage Radiation Therapy: the PERYTON-Guideline

F H E Staal; J Janssen; D E Oprea-Lager; A M Engelen; E J van Limbergen; R J Smeenk; M A A de Jong; T C G Budiharto; I Jacobs; M A D Haverkort; C L Brouwer; K Ng Wei Siang; J A Langendijk; J F Verzijlbergen; I J de Jong; W Noordzij; S Aluwini

doi:10.1016/j.ijrobp.2023.09.016

Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Based Clinical Target Volume Delineation Guideline for Postprostatectomy Salvage Radiation Therapy: the PERYTON-Guideline

F H E Staal^*, J Janssen, D E Oprea-Lager, A M Engelen, E J van Limbergen, R J Smeenk, M A A de Jong, T C G Budiharto, I Jacobs, M A D Haverkort, C L Brouwer, K Ng Wei Siang, J A Langendijk, J F Verzijlbergen, I J de Jong, W Noordzij, S Aluwini

^*Corresponding author voor dit werk

Onderzoeksoutput › Academic › peer review

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PURPOSE: PSMA PET/CT scan is the standard imaging procedure for biochemical recurrent prostate cancer post-prostatectomy due to its high detection rate at low serum PSA levels. However, existing guidelines for clinical target volume (CTV) in prostate bed salvage external beam radiation therapy (sEBRT) are primarily based on experience-based clinical consensus and have been validated using conventional imaging modalities. Therefore, this study aimed to optimize CTV definition in sEBRT by utilizing PSMA PET/CT-detected local recurrences (LRs).

METHODS AND MATERIALS: Patients with suspected LR on PSMA PET/CT post-prostatectomy were retrospectively enrolled in nine Dutch centers. Anonymized scans were centrally reviewed by an expert nuclear medicine physician. Each boundary of the CTV guideline from the Groupe Francophone de Radiothérapie en Urologie (GFRU) was evaluated and adapted to improve the accuracy and coverage of the area at risk of LR (CTV) on PSMA PET/CT. The proposed CTV adaptation was discussed with the radiation oncologists of the participating centers, and final consensus was reached. To assess reproducibility, the participating centers were asked to delineate three new cases according to the new PERYTON-CTV, and the submitted contours were evaluated using the dice similarity coefficient (DSC).

RESULTS: After central review, 93 LRs were identified on 83 PSMA PET/CTs. The proposed CTV definition improved the coverage of PSMA PET/CT-detected LRs from 67% to 96% compared to the GFRU-CTV, while reducing the GFRU-CTV volume with 25%. The new CTV was highly reproducible with a mean DSC of 0.82 (range: 0.81 to 0.83).

CONCLUSIONS: This study contributes to the optimization of CTV definition in post-prostatectomy sEBRT by using the pattern of LR detected on PSMA PET/CT. The PERYTON-CTV is highly reproducible across the participating centers and ensures coverage of 96% LRs while reducing the GFRU-CTV volume with 25%.

Originele taal-2	English
Pagina's (van-tot)	688-696
Aantal pagina's	9
Tijdschrift	International Journal of Radiation Oncology, Biology, Physics
Volume	118
Nummer van het tijdschrift	3
Vroegere onlinedatum	18-sep.-2023
DOI's	https://doi.org/10.1016/j.ijrobp.2023.09.016
Status	Published - 1-mrt.-2024

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10.1016/j.ijrobp.2023.09.016

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Staal, F. H. E., Janssen, J., Oprea-Lager, D. E., Engelen, A. M., van Limbergen, E. J., Smeenk, R. J., de Jong, M. A. A., Budiharto, T. C. G., Jacobs, I., Haverkort, M. A. D., Brouwer, C. L., Siang, K. N. W., Langendijk, J. A., Verzijlbergen, J. F., de Jong, I. J., Noordzij, W., & Aluwini, S. (2024). Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Based Clinical Target Volume Delineation Guideline for Postprostatectomy Salvage Radiation Therapy: the PERYTON-Guideline. International Journal of Radiation Oncology, Biology, Physics, 118(3), 688-696. https://doi.org/10.1016/j.ijrobp.2023.09.016

@article{9a66ab3f6f3447e5ad644da2ec1eb03c,

title = "Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Based Clinical Target Volume Delineation Guideline for Postprostatectomy Salvage Radiation Therapy: the PERYTON-Guideline",

abstract = "PURPOSE: PSMA PET/CT scan is the standard imaging procedure for biochemical recurrent prostate cancer post-prostatectomy due to its high detection rate at low serum PSA levels. However, existing guidelines for clinical target volume (CTV) in prostate bed salvage external beam radiation therapy (sEBRT) are primarily based on experience-based clinical consensus and have been validated using conventional imaging modalities. Therefore, this study aimed to optimize CTV definition in sEBRT by utilizing PSMA PET/CT-detected local recurrences (LRs).METHODS AND MATERIALS: Patients with suspected LR on PSMA PET/CT post-prostatectomy were retrospectively enrolled in nine Dutch centers. Anonymized scans were centrally reviewed by an expert nuclear medicine physician. Each boundary of the CTV guideline from the Groupe Francophone de Radioth{\'e}rapie en Urologie (GFRU) was evaluated and adapted to improve the accuracy and coverage of the area at risk of LR (CTV) on PSMA PET/CT. The proposed CTV adaptation was discussed with the radiation oncologists of the participating centers, and final consensus was reached. To assess reproducibility, the participating centers were asked to delineate three new cases according to the new PERYTON-CTV, and the submitted contours were evaluated using the dice similarity coefficient (DSC).RESULTS: After central review, 93 LRs were identified on 83 PSMA PET/CTs. The proposed CTV definition improved the coverage of PSMA PET/CT-detected LRs from 67% to 96% compared to the GFRU-CTV, while reducing the GFRU-CTV volume with 25%. The new CTV was highly reproducible with a mean DSC of 0.82 (range: 0.81 to 0.83).CONCLUSIONS: This study contributes to the optimization of CTV definition in post-prostatectomy sEBRT by using the pattern of LR detected on PSMA PET/CT. The PERYTON-CTV is highly reproducible across the participating centers and ensures coverage of 96% LRs while reducing the GFRU-CTV volume with 25%.",

author = "Staal, {F H E} and J Janssen and Oprea-Lager, {D E} and Engelen, {A M} and {van Limbergen}, {E J} and Smeenk, {R J} and {de Jong}, {M A A} and Budiharto, {T C G} and I Jacobs and Haverkort, {M A D} and Brouwer, {C L} and Siang, {K Ng Wei} and Langendijk, {J A} and Verzijlbergen, {J F} and {de Jong}, {I J} and W Noordzij and S Aluwini",

note = "Copyright {\textcopyright} 2023. Published by Elsevier Inc.",

year = "2024",

month = mar,

day = "1",

doi = "10.1016/j.ijrobp.2023.09.016",

language = "English",

volume = "118",

pages = "688--696",

journal = "International Journal of Radiation Oncology, Biology, Physics",

issn = "0360-3016",

publisher = "ELSEVIER SCIENCE INC",

number = "3",

}

Staal, FHE , Janssen, J, Oprea-Lager, DE, Engelen, AM, van Limbergen, EJ, Smeenk, RJ, de Jong, MAA, Budiharto, TCG, Jacobs, I, Haverkort, MAD, Brouwer, CL, Siang, KNW, Langendijk, JA, Verzijlbergen, JF, de Jong, IJ , Noordzij, W & Aluwini, S 2024, 'Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Based Clinical Target Volume Delineation Guideline for Postprostatectomy Salvage Radiation Therapy: the PERYTON-Guideline', International Journal of Radiation Oncology, Biology, Physics, vol. 118, nr. 3, blz. 688-696. https://doi.org/10.1016/j.ijrobp.2023.09.016

Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Based Clinical Target Volume Delineation Guideline for Postprostatectomy Salvage Radiation Therapy: the PERYTON-Guideline. / Staal, F H E ; Janssen, J; Oprea-Lager, D E et al.
In: International Journal of Radiation Oncology, Biology, Physics, Vol. 118, Nr. 3, 01.03.2024, blz. 688-696.

Onderzoeksoutput › Academic › peer review

TY - JOUR

T1 - Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Based Clinical Target Volume Delineation Guideline for Postprostatectomy Salvage Radiation Therapy

T2 - the PERYTON-Guideline

AU - Staal, F H E

AU - Janssen, J

AU - Oprea-Lager, D E

AU - Engelen, A M

AU - van Limbergen, E J

AU - Smeenk, R J

AU - de Jong, M A A

AU - Budiharto, T C G

AU - Jacobs, I

AU - Haverkort, M A D

AU - Brouwer, C L

AU - Siang, K Ng Wei

AU - Langendijk, J A

AU - Verzijlbergen, J F

AU - de Jong, I J

AU - Noordzij, W

AU - Aluwini, S

PY - 2024/3/1

Y1 - 2024/3/1

N2 - PURPOSE: PSMA PET/CT scan is the standard imaging procedure for biochemical recurrent prostate cancer post-prostatectomy due to its high detection rate at low serum PSA levels. However, existing guidelines for clinical target volume (CTV) in prostate bed salvage external beam radiation therapy (sEBRT) are primarily based on experience-based clinical consensus and have been validated using conventional imaging modalities. Therefore, this study aimed to optimize CTV definition in sEBRT by utilizing PSMA PET/CT-detected local recurrences (LRs).METHODS AND MATERIALS: Patients with suspected LR on PSMA PET/CT post-prostatectomy were retrospectively enrolled in nine Dutch centers. Anonymized scans were centrally reviewed by an expert nuclear medicine physician. Each boundary of the CTV guideline from the Groupe Francophone de Radiothérapie en Urologie (GFRU) was evaluated and adapted to improve the accuracy and coverage of the area at risk of LR (CTV) on PSMA PET/CT. The proposed CTV adaptation was discussed with the radiation oncologists of the participating centers, and final consensus was reached. To assess reproducibility, the participating centers were asked to delineate three new cases according to the new PERYTON-CTV, and the submitted contours were evaluated using the dice similarity coefficient (DSC).RESULTS: After central review, 93 LRs were identified on 83 PSMA PET/CTs. The proposed CTV definition improved the coverage of PSMA PET/CT-detected LRs from 67% to 96% compared to the GFRU-CTV, while reducing the GFRU-CTV volume with 25%. The new CTV was highly reproducible with a mean DSC of 0.82 (range: 0.81 to 0.83).CONCLUSIONS: This study contributes to the optimization of CTV definition in post-prostatectomy sEBRT by using the pattern of LR detected on PSMA PET/CT. The PERYTON-CTV is highly reproducible across the participating centers and ensures coverage of 96% LRs while reducing the GFRU-CTV volume with 25%.

AB - PURPOSE: PSMA PET/CT scan is the standard imaging procedure for biochemical recurrent prostate cancer post-prostatectomy due to its high detection rate at low serum PSA levels. However, existing guidelines for clinical target volume (CTV) in prostate bed salvage external beam radiation therapy (sEBRT) are primarily based on experience-based clinical consensus and have been validated using conventional imaging modalities. Therefore, this study aimed to optimize CTV definition in sEBRT by utilizing PSMA PET/CT-detected local recurrences (LRs).METHODS AND MATERIALS: Patients with suspected LR on PSMA PET/CT post-prostatectomy were retrospectively enrolled in nine Dutch centers. Anonymized scans were centrally reviewed by an expert nuclear medicine physician. Each boundary of the CTV guideline from the Groupe Francophone de Radiothérapie en Urologie (GFRU) was evaluated and adapted to improve the accuracy and coverage of the area at risk of LR (CTV) on PSMA PET/CT. The proposed CTV adaptation was discussed with the radiation oncologists of the participating centers, and final consensus was reached. To assess reproducibility, the participating centers were asked to delineate three new cases according to the new PERYTON-CTV, and the submitted contours were evaluated using the dice similarity coefficient (DSC).RESULTS: After central review, 93 LRs were identified on 83 PSMA PET/CTs. The proposed CTV definition improved the coverage of PSMA PET/CT-detected LRs from 67% to 96% compared to the GFRU-CTV, while reducing the GFRU-CTV volume with 25%. The new CTV was highly reproducible with a mean DSC of 0.82 (range: 0.81 to 0.83).CONCLUSIONS: This study contributes to the optimization of CTV definition in post-prostatectomy sEBRT by using the pattern of LR detected on PSMA PET/CT. The PERYTON-CTV is highly reproducible across the participating centers and ensures coverage of 96% LRs while reducing the GFRU-CTV volume with 25%.

U2 - 10.1016/j.ijrobp.2023.09.016

DO - 10.1016/j.ijrobp.2023.09.016

M3 - Article

C2 - 37729971

SN - 0360-3016

VL - 118

SP - 688

EP - 696

JO - International Journal of Radiation Oncology, Biology, Physics

JF - International Journal of Radiation Oncology, Biology, Physics

IS - 3

ER -

Staal FHE , Janssen J, Oprea-Lager DE, Engelen AM, van Limbergen EJ, Smeenk RJ et al. Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Based Clinical Target Volume Delineation Guideline for Postprostatectomy Salvage Radiation Therapy: the PERYTON-Guideline. International Journal of Radiation Oncology, Biology, Physics. 2024 mrt. 1;118(3):688-696. Epub 2023 sep. 18. doi: 10.1016/j.ijrobp.2023.09.016