Combined Ventilation and Perfusion Imaging Correlates With the Dosimetric Parameters of Radiation Pneumonitis in Radiation Therapy Planning for Lung Cancer

Kimura, Tomoki; Doi, Yoshiko; Nakashima, Takeo; Imano, Nobuki; Kawabata, Hideo; Nishibuchi, Ikuno; Okabe, Takao; Kenjo, Masahiro; Ozawa, Shogo; Murakami, Yuji; Nagata, Yasushi

doi:10.1016/j.ijrobp.2015.08.024

Cited by 29 publications

(21 citation statements)

References 24 publications

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“…Ventilation differences introduced by registration errors can be reduced by smoothing. This evaluation study and previous reports 15 , 18 support the use of ventilation calculated using 4D CT in clinical applications such as radiation treatment planning, 12 , 23 , 24 , 40 , 42 , 43 , 44 , 45 pulmonary function, 15 , 18 and lung disease (22) …”

Section: Resultssupporting

confidence: 79%

“…For example, 4D CT‐based ventilation has been used in radiation therapy treatment planning to avoid functional lung and to estimate loss of lung function or normal tissue toxicity after radiotherapy in a dose‐dependent manner 40 , 42 , 43 , 44 , 45 . Additional medical applications, such as in diagnostic imaging, may be possible.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the ΔV 4D CT ventilation calculation method usingin vivoxenon CT ventilation data and comparison to other methods

Zhang

Latifi

et al. 2016

J Applied Clin Med Phys

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Ventilation distribution calculation using 4D CT has shown promising potential in several clinical applications. This study evaluated the direct geometric ventilation calculation method, namely the ΔV method, with xenon‐enhanced CT (XeCT) ventilation data from four sheep, and compared it with two other published methods, the Jacobian and the Hounsfield unit (HU) methods. Spearman correlation coefficient (SCC) and Dice similarity coefficient (DSC) were used for the evaluation and comparison. The average SCC with one standard deviation was 0.44±0.13 with a range between 0.29 and 0.61 between the XeCT and DLV ventilation distributions. The average DSC value for lower 30% ventilation volumes between the XeCT and ΔV ventilation distributions was 0.55±0.07 with a range between 0.48 and 0.63. Ventilation difference introduced by deformable image registration errors improved with smoothing. In conclusion, ventilation distributions generated using ΔV‐4D CT and deformable image registration are in reasonably agreement with the in vivo XeCT measured ventilation distribution.PACS number(s): 87.57.N‐, 87.57.nj, 87.57.Q‐, 87.85.Pq

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Section: Resultssupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Evaluation of the ΔV 4D CT ventilation calculation method usingin vivoxenon CT ventilation data and comparison to other methods

Zhang

Latifi

et al. 2016

J Applied Clin Med Phys

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“…The most frequently proposed use of 4DCT-ventilation is for functional avoidance radiation therapy; which implies designing the radiation treatment plan to avoid functional portions of the lung (as measured by 4DCT-ventilation) [11–13]. The idea is that if functional portions of the lung received less dose the probability of developing thoracic radiation related side-effects (radiation pneumonitis for example) would decrease [11, 14]. The development of prospective clinical trials is underway to use hyperpolarize-helium MRI for functional avoidance and to evaluate 4DCT-ventilation as a functional imaging modality for functional avoidance [15].…”

Section: Introductionmentioning

confidence: 99%

Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy

Vinogradskiy

Schubert

Diot

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Purpose 4DCT-ventilation is an exciting imaging modality that uses 4DCT data to calculate lung function maps. The development of clinical trials is underway to use 4DCT-ventilation imaging to preferentially spare functional lung in patients undergoing radiotherapy. The purpose of this work was to generate data to aide with clinical trial design by retrospectively characterizing dosimetric and functional profiles for patients with different stages of lung cancer disease Methods and Materials A total of 118 lung cancer patients (36% stage I and 64% stage III) from 2 institutions were used for the study. A 4DCT-ventilation map was calculated using the patient’s 4DCT imaging, deformable image registration, and a density-change based algorithm. In order to assess each patient’s spatial ventilation profile both quantitative and qualitative metrics were developed including an observer-based defect observation and metrics based on the ventilation in each lung third. For each patient we used the clinical doses to calculate weighted mean lung doses (fMLD) and metrics that assessed the interplay between the spatial location of the dose and high-functioning lung. Results Both qualitative and quantitative metrics revealed a significant difference in functional profiles between the 2 stage groups (p<0.01). We determined that 65% of stage III and 28% of stage I patients had ventilation defects. Average fMLD was 19.6 Gy and 5.4 Gy for stage III and I patients respectively with both groups containing patients with large spatial overlap between dose and high-function regions. Conclusion Our 118 patient retrospective study found that 65% stage III patients have regionally variant ventilation profiles that are suitable for functional avoidance. Our results suggest that regardless of disease stage, it is possible to have unique spatial interplay between dose and high-functional lung highlighting the importance of evaluating the function of each patient and developing a personalized functional avoidance treatment approach.

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“…Some studies have related the incidence of RILT to the functional dosimetric parameters based on Q-SPECT45678910 which adds more accurate predictive value than that on anatomical CT. V-SPECT predicting RILT were rarely reported in previous studies, while a few researches have indicated that the use of V-SPECT can be used for guiding radiation beam arrangement in NSCLC111213. Our prior study14 demonstrated that the V defects and Q defects were mismatched in some patients with NSCLC, and V/Q-SPECT would thus provide a more comprehensive pulmonary function assessment for their application in RT planning.…”

mentioning

confidence: 99%

To Find a Better Dosimetric Parameter in the Predicting of Radiation-Induced Lung Toxicity Individually: Ventilation, Perfusion or CT based

Xiao

Yang

Chen

et al. 2017

Sci Rep

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This study aimed to find a better dosimetric parameter in predicting of radiation-induced lung toxicity (RILT) in patients with non-small cell lung cancer (NSCLC) individually: ventilation(V), perfusion (Q) or computerized tomography (CT) based. V/Q single-photon emission computerized tomography (SPECT) was performed within 1 week prior to radiotherapy (RT). All V/Q imaging data was integrated into RT planning system, generating functional parameters based on V/Q SPECT. Fifty-seven NSCLC patients were enrolled in this prospective study. Fifteen (26.3%) patients underwent grade ≥2 RILT, the remaining forty-two (73.7%) patients didn’t. Q-MLD, Q-V20, V-MLD, V-V20 of functional parameters correlated more significantly with the occurrence of RILT compared to V20, MLD of anatomical parameters (r = 0.630; r = 0.644; r = 0.617; r = 0.651 vs. r = 0.424; r = 0.520 p < 0.05, respectively). In patients with chronic obstructive pulmonary diseases (COPD), V functional parameters reflected significant advantage in predicting RILT; while in patients without COPD, Q functional parameters reflected significant advantage. Analogous results were existed in fractimal analysis of global pulmonary function test (PFT). In patients with central-type NSCLC, V parameters were better than Q parameters; while in patients with peripheral-type NSCLC, the results were inverse. Therefore, this study demonstrated that choosing a suitable dosimetric parameter individually can help us predict RILT accurately.

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Combined Ventilation and Perfusion Imaging Correlates With the Dosimetric Parameters of Radiation Pneumonitis in Radiation Therapy Planning for Lung Cancer

Cited by 29 publications

References 24 publications

Evaluation of the ΔV 4D CT ventilation calculation method usingin vivoxenon CT ventilation data and comparison to other methods

Evaluation of the ΔV 4D CT ventilation calculation method usingin vivoxenon CT ventilation data and comparison to other methods

Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy

To Find a Better Dosimetric Parameter in the Predicting of Radiation-Induced Lung Toxicity Individually: Ventilation, Perfusion or CT based

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