Radiation-Induced Reductions in Regional Lung Perfusion: 0.1–12 Year Data From a Prospective Clinical Study

Zhang, Junan; Ma, Jinli; Zhou, Sumin; Hubbs, Jessica L.; Wong, Terence Z.; Folz, Rodney J.; Evans, Elizabeth S.; Jaszczak, R.J.; Clough, Robert; Marks, Lawrence B.

doi:10.1016/j.ijrobp.2009.02.005

Cited by 67 publications

(61 citation statements)

References 44 publications

(54 reference statements)

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“…Several other groups also suggested similar global normalization by scaling entire ventilation map with factors derived from ventilation values in a ROI or lobe that is uninvolved by radiation. 10,18,19 Although true when averaged over all voxels within the lung, in this paper we have shown the ventilation rate of lung tissue is not uniform either spatially or temporally when studied at the voxel level. As shown in Fig.…”

Section: Discussionmentioning

confidence: 71%

“…Modified versions of global normalization 10,18,19 and the percentile method 4,7,10,17 might be options in the case of the single scan scenario. However, the global normalization has limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Vinogradskiy et al 10 used another normalizing method proposed by Seppenwoolde et al 18 They defined a normalization factor calculated from well-ventilated low-dose regions and applied it to the entire image. Similarly, Zhang et al 19 corrected SPECT scans for effort differences with a global scaling factor derived from a region of interest in the uninvolved lobe. Both Refs.…”

Section: Introductionmentioning

confidence: 99%

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Respiratory effort correction strategies to improve the reproducibility of lung expansion measurements

Reinhardt

Christensen

et al. 2013

Medical Physics

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Purpose: Four-dimensional computed tomography (4DCT) can be used to make measurements of pulmonary function longitudinally. The sensitivity of such measurements to identify change depends on measurement uncertainty. Previously, intrasubject reproducibility of Jacobian-based measures of lung tissue expansion was studied in two repeat prior-RT 4DCT human acquisitions. Difference in respiratory effort such as breathing amplitude and frequency may affect longitudinal function assessment. In this study, the authors present normalization schemes that correct ventilation images for variations in respiratory effort and assess the reproducibility improvement after effort correction. Methods: Repeat 4DCT image data acquired within a short time interval from 24 patients prior to radiation therapy (RT) were used for this analysis. Using a tissue volume preserving deformable image registration algorithm, Jacobian ventilation maps in two scanning sessions were computed and compared on the same coordinate for reproducibility analysis. In addition to computing the ventilation maps from end expiration to end inspiration, the authors investigated the effort normalization strategies using other intermediated inspiration phases upon the principles of equivalent tidal volume (ETV) and equivalent lung volume (ELV). Scatter plots and mean square error of the repeat ventilation maps and the Jacobian ratio map were generated for four conditions: no effort correction, global normalization, ETV, and ELV. In addition, gamma pass rate was calculated from a modified gamma index evaluation between two ventilation maps, using acceptance criterions of 2 mm distanceto-agreement and 5% ventilation difference. Results: The pattern of regional pulmonary ventilation changes as lung volume changes. All effort correction strategies improved reproducibility when changes in respiratory effort were greater than 150 cc (p < 0.005 with regard to the gamma pass rate). Improvement of reproducibility was correlated with respiratory effort difference (R = 0.744 for ELV in the cohort with tidal volume difference greater than 100 cc). In general for all subjects, global normalization, ETV and ELV significantly improved reproducibility compared to no effort correction (p = 0.009, 0.002, 0.005 respectively). When tidal volume difference was small (less than 100 cc), none of the three effort correction strategies improved reproducibility significantly (p = 0.52, 0.46, 0.46 respectively). For the cohort (N = 13) with tidal volume difference greater than 100 cc, the average gamma pass rate improves from 57.3% before correction to 66.3% after global normalization, and 76.3% after ELV. ELV was found to be significantly better than global normalization (p = 0.04 for all subjects, and p = 0.003 for the cohort with tidal volume difference greater than 100 cc). Conclusions: All effort correction strategies improve the reproducibility of the authors' pulmonary ventilation measures, and the improvement of reproducibility is highly correlated with the changes in respiratory e...

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Respiratory effort correction strategies to improve the reproducibility of lung expansion measurements

Reinhardt

Christensen

et al. 2013

Medical Physics

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“…Although lung function can be reduced irreversibly by radiation therapy [4,134,135], it has also been known for many years that the tumour itself can be responsible for reduced lung function [9] when bronchial obstruction and large vessel compression create regional ventilation and perfusion defects that become tempting targets for functionally-guided dose redistribution. Therefore, a potential limitation of normal lung avoidance is that lung volumes that may have received a functionally modified, amplified dose may regain some degree of function following treatment [4]; an effect noticeable on SPECT [136], PET [135], hyperpolarised gas MRI [63,137,138] and CT- [32,139] and even part way through treatment [135,140,141].…”

Section: Potential Limitations Of Normal Lung Avoidancementioning

confidence: 99%

“…Therefore, a potential limitation of normal lung avoidance is that lung volumes that may have received a functionally modified, amplified dose may regain some degree of function following treatment [4]; an effect noticeable on SPECT [136], PET [135], hyperpolarised gas MRI [63,137,138] and CT- [32,139] and even part way through treatment [135,140,141]. Hence, whether defects are transient [142,143], reversible [136] or persistent [134] becomes an important issue when assigning functional and non-functional planning constraints.…”

Section: Potential Limitations Of Normal Lung Avoidancementioning

confidence: 99%

Functional Image-guided Radiotherapy Planning for Normal Lung Avoidance

et al. 2016

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ReuseThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) licence. This licence only allows you to download this work and share it with others as long as you credit the authors, but you can't change the article in any way or use it commercially. More information and the full terms of the licence here: https://creativecommons.org/licenses/ Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. 1 AbstractFor patients with lung cancer undergoing curative intent radiotherapy, functional lung imaging can be incorporated into treatment planning to modify the dose distribution within non-target volume lung by differentiation of lung regions that are functionally defective or viable. This concept of functional image-guided lung avoidance treatment planning has been investigated with several imaging modalities, primarily SPECT but also hyperpolarised gas MRI, PET and CT-based measures of lung biomechanics. Here, we review the application of each of these modalities, review practical issues of lung avoidance implementation, including image registration and the role of both ventilation and perfusion imaging, and provide guidelines for reporting of future lung avoidance planning studies.

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Cardiac metabolic changes on ¹⁸F‐positron emission tomography after thoracic radiotherapy predict for overall survival in esophageal cancer patients

Zakem

Jones

Castillo

et al. 2022

J Applied Clin Med Phys

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PurposeHeart doses have been shown to be predictive of cardiac toxicity and overall survival (OS) for esophageal cancer patients. There is potential for functional imaging to provide valuable cardiac information. The purpose of this study was to evaluate the cardiac metabolic dose–response using 18F‐deoxyglucose (FDG)–PET and to assess whether standard uptake value (SUV) changes in the heart were predictive of OS.MethodsFifty‐one patients with esophageal cancer treated with radiation who underwent pre‐ and post‐treatment FDG–PET scans were retrospectively evaluated. Pre‐ and post‐treatment PET‐scans were rigidly registered to the planning CT for each patient. Pre‐treatment to post‐treatment absolute mean SUV (SUVmean) changes in the heart were calculated to assess dose–response. A dose–response curve was generated by binning each voxel in the heart into 10 Gy dose‐bins and analyzing the SUVmean changes in each dose‐bin. Multivariate cox proportional hazard models were used to assess whether pre‐to‐post treatment cardiac SUVmean changes predicted for OS.ResultsThe cardiac dose–response curve demonstrated a trend of increasing cardiac SUV changes as a function of dose with an average increase of 0.044 SUV for every 10 Gy dose bin. In multivariate analysis, disease stage and SUVmean change in the heart were predictive (p < 0.05) for OS.ConclusionsChanges in pre‐ to post‐treatment cardiac SUV were predictive of OS with patients having a higher pre‐ to post‐treatment cardiac SUV change surviving longer.

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Radiation-Induced Reductions in Regional Lung Perfusion: 0.1–12 Year Data From a Prospective Clinical Study

Cited by 67 publications

References 44 publications

Respiratory effort correction strategies to improve the reproducibility of lung expansion measurements

Respiratory effort correction strategies to improve the reproducibility of lung expansion measurements

Functional Image-guided Radiotherapy Planning for Normal Lung Avoidance

Cardiac metabolic changes on ¹⁸F‐positron emission tomography after thoracic radiotherapy predict for overall survival in esophageal cancer patients

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Radiation-Induced Reductions in Regional Lung Perfusion: 0.1–12 Year Data From a Prospective Clinical Study

Cited by 67 publications

References 44 publications

Respiratory effort correction strategies to improve the reproducibility of lung expansion measurements

Respiratory effort correction strategies to improve the reproducibility of lung expansion measurements

Functional Image-guided Radiotherapy Planning for Normal Lung Avoidance

Cardiac metabolic changes on 18F‐positron emission tomography after thoracic radiotherapy predict for overall survival in esophageal cancer patients

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Cardiac metabolic changes on ¹⁸F‐positron emission tomography after thoracic radiotherapy predict for overall survival in esophageal cancer patients