Regional Normal Lung Tissue Density Changes in Patients Treated With Stereotactic Body Radiation Therapy for Lung Tumors

Diot, Quentin; Kavanagh, Brian D.; Schefter, Tracey E.; Gaspar, Laurie E.; Stuhr, Kelly; Miften, Moyed

doi:10.1016/j.ijrobp.2011.11.080

Cited by 55 publications

(70 citation statements)

References 31 publications

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“…In the highest dose bin (62.5-67.5 Gy), a steep rise or decrease in lung density was observed in some patients. This phenomenon has been observed in other studies [22] and may be due to density increases complicating proper segmentation and registration of lung tissue. Comparing changes in DS with Dmean with reference to their detection levels (dotted horizontal lines), DS changes can be detected at lower dose levels than Dmean (Fig.…”

Section: Resultssupporting

confidence: 63%

A new CT-based method to quantify radiation-induced lung damage in patients

Ghobadi

Wiegman

Langendijk

et al. 2015

Radiotherapy and Oncology

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Section: Resultssupporting

confidence: 63%

A new CT-based method to quantify radiation-induced lung damage in patients

Ghobadi

Wiegman

Langendijk

et al. 2015

Radiotherapy and Oncology

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“…All of the severe RP cases in our institution consisted of the acute exacerbation of IP that was spread out over the radiation field (Figure 2) [39] . The analysis of SBRT-induced normal lung density changes by Diot et al [6] indicates that self-limiting acute effects in normal lung tissue are more pronounced than late effects, and acute CT changes in patients treated with 3 fractions were considerably less than those in patients treated with 4 or 5 fractions. The changes seemed to be explained by either increased low-dose exposure in normal lung tissue or differences in tumor volume.…”

Section: Timeline and Pattern Of Ct Changesmentioning

confidence: 99%

“…Given the improved local control and toxicity results reported by recent lung SBRT studies [1][2][3][4] , future directions for this technique include the treatment of larger lesions. Palma et al [5] and Diot et al [6] suggest that toxicity might increase with lesion size, and this possibility should be anticipated and closely monitored.…”

Section: Introductionmentioning

confidence: 99%

Radiation pneumonitis after stereotactic radiation therapy for lung cancer

Yamashita

Takahashi

Haga

et al. 2014

WJR

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Stereotactic body radiation therapy (SBRT) has a local control rate of 95% at 2 years for non-small cell lung cancer (NSCLC) and should improve the prognosis of inoperable patients, elderly patients, and patients with significant comorbidities who have early-stage NSCLC. The safety of SBRT is being confirmed in international, multi-institutional Phase Ⅱ trials for peripheral lung cancer in both inoperable and operable patients, but reports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer. Radiation pneumonitis (RP) is one of the most common toxicities of SBRT. Although most post-treatment RP is Grade 1 or 2 and either asymptomatic or manageable, a few cases are severe, symptomatic, and there is a risk for mortality. The reported rates of symptomatic RP after SBRT range from 9% to 28%. Being able to predict the risk of RP after SBRT is extremely useful in treatment planning. A dose-effect relationship has been demonstrated, but suggested dose-volume factors like mean lung dose, lung V20, and/or lung V2.5 differed among the reports. We found that patients who present with an interstitial pneumonitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumonitis after SBRT. At our institution, lung cancer patients with these risk factors have not received SBRT since 2006, and our rate of severe RP after SBRT has decreased significantly since then.

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“…3,5,[11][12][13] It has been reported that radiation can lead to electron density changes in the lung and liver, as observed from CT images. [14][15][16][17][18] The CT number (CTN) changes were found to be associated with radiation injuries.…”

Section: Introductionmentioning

confidence: 99%

Radiation-induced CT number changes in GTV and parotid glands during the course of radiation therapy for nasopharyngeal cancer

Yang

et al. 2016

BJR

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Objective: To investigate the changes in CT number (CTN) in gross tumour volume (GTV) and organs at risk (OARs) during the course of radiation therapy (RT) for nasopharyngeal cancer (NPC). Methods: Daily megavoltage CT (MVCT) data collected from 30 patients with NPC treated with a prescription dose of 70 Gy in 30-33 fractions using helical tomotherapy were retrospectively analyzed. The contours of GTV and OARs on daily MVCTs were obtained by populating the planning contours from planning CT to daily MVCTs with manual editing, if necessary. The changes of GTV and OAR volumes and the histograms of CTN in the GTV and OARs during the course of RT delivery were analyzed. Results: Volumes of GTV and parotid glands were reduced during the course of radiation treatment, with an average shrinkage rate of 0.23% per day (range, 0.02-0.8%) and 1.2% per day (range, 0.2-2.3%), respectively. The mean CTN changes in GTV and ipsilateral and contralateral parotid glands were reduced by 52 6 35 HU, 18 6 20 HU and 17 6 22 HU, respectively. For GTV, the CTN and GTV volume decreases were found to be correlated with each other (p , 0.0001). No noticeable CTN change was found in the spinal cord and non-specified tissue irradiated with low doses. Conclusion: The CTN changes in GTV and parotids are measurable during the delivery of fractionated radiotherapy for NPC, were associated with the doses received (the number of fractions delivered) and were patient specific. Advances in knowledge: The CTN change during radiotherapy is dose dependent and is measurable for NPC.

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Regional Normal Lung Tissue Density Changes in Patients Treated With Stereotactic Body Radiation Therapy for Lung Tumors

Cited by 55 publications

References 31 publications

A new CT-based method to quantify radiation-induced lung damage in patients

A new CT-based method to quantify radiation-induced lung damage in patients

Radiation pneumonitis after stereotactic radiation therapy for lung cancer

Radiation-induced CT number changes in GTV and parotid glands during the course of radiation therapy for nasopharyngeal cancer

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