Radiation Therapy Planning of Non-small Cell Lung Cancer based on PET/CT. (Diagnostic component)

Closed for proposals

Project Type

Coordinated Research Project

Project Code




Approved Date

13 November 2013



Start Date

29 May 2014

Expected End Date

31 December 2018

Completed Date

3 May 2019


Non-small Cell Lung Cancer (NSCLC) is considered in many countries as a leading cause of cancer related morbidity and mortality. While curative radiation therapy can be performed on patients who are surgically inoperable, local control and overall survival rates have historically been low, possibly due to inappropriate selection of patients and uncertainties in target definition.  It is hoped that 18F-Fluorodeoxyglucose (18F-FDG) PET/CT based radiation therapy treatment planning (RTP) would enable appropriate selection of patients who would benefit from curative radiation therapy and improve Target Volume Definition (TVD), leading to better outcomes following curative radiation therapy. Aiming at standardising PET/CT based Radio Therapy Planning (RTP) and improving clinical outcomes for patients diagnosed with NSCLC, the IAEA Division of Human Health has initiated two Coordinated Research Projects (CRPs), E13042 and E33038, with one titled “Radiation Therapy Planning of Non-small cell lung cancer based on PET/CT“. These CRPs complement each other and will be conducted respectively by the Nuclear Medicine and Diagnostic Imaging Section (NMDI) and the Applied Radiation Biology and Radiotherapy Section (ARBR).While CRP E13042, conducted by NMDI, will focus on the diagnostic aspects of introducing 18F-FDG PET/CT for RTP including quality control, acquisition and processing protocols, and imaging analysis and interpretation; CRP E33038, conducted by ARBR, will concentrate on the PET/CT utilization for the TVD and on the clinical outcomes of such treatment approach. PET/CT for radiation therapy treatment planning will be introduced to patients with stage III A/B NSCLC in participating centres that are suitably equipped but unable to implement this technology properly. To achieve this goal CRP E13042 will be conducted in two phases; a preparatory phase to acquire and maintain competencies in PET/CT based RTP for NSCLC, followed by a prospective clinical trial to evaluate the effect of PET/CT based RTP in recruited patients. Research institutions willing to participate in these CRPs must have the required infrastructure and be able to nominate two chief scientific investigators, one from the nuclear medicine department to be involved in the diagnostic component of E13042 and the other from the radiation oncology department to work on the activities related to E33038.  


Determine the impact of PET/CT in RTP on 2-year overall survival rates for patients with stage III NSCLC receiving chemo-radiotherapy with curative intent.

Specific objectives

To improve the overall survival in patients with NSCLC by the use of PET/CT-based TVD for the purposes of RTP.

To improve the quality and reproducibility of PET/CT-based radiation therapy target volume definition in patients with NSCLC by means of a training intervention

CRP Publications


Abstract presented at international conference




Presented at: ESTRO 2015


Title: Multiple training interventions significantly improve PET/CT based lung cancer radiotherapy target volume delineation following a standardized delineation protocol in an IAEA study.Authors: Tom Konert, Wouter Vogel, Michael P. MacManus, Sarah Everitt, Daniela Thorwarth, Jan Jakob Sonke, Diana Paez, Elena Fidarova, Gerard G. Hanna


Peer review journal




Journal: Radiotherapy and Oncology 116 (2015) 27–34


Title: IAEA consensus report PET/CT imaging for target volume delineation in curative intent radiotherapy of non-small cell lung cancer: IAEA consensus report 2014.Authors: Tom Konert , Wouter Vogel, Michael P. MacManus, Ursula Nestle, José Belderbos, Vincent Grégoire, Daniela Thorwarth, Elena Fidarova, Diana Paez, Arturo Chiti, Gerard G. Hanna

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