Semiquantification and Classification of Local Pulmonary Function by V/Q Single Photon Emission Computed Tomography in Patients with Non-small Cell Lung Cancer: Potential Indication for Radiotherapy Planning

Yuan, Shuanghu; Frey, Kirk A.; Gross, Milton D.; Hayman, James A.; Curtis, Jeffrey L.; Cai, Xu-Wei; Ramnath, Nithya; Kalemkerian, Gregory P.; Haken, Randall K. Ten; Eisbruch, Avraham; Kong, Feng-Ming

doi:10.1097/jto.0b013e3181f77b40

Cited by 39 publications

(34 citation statements)

References 18 publications

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“…It indicated that lower radiation dose to the normal lung tissue gained better protection. Yuan et al (2011) found that it was difficult to generate detailed conclusions about which patients are most likely to benefit from CT and SPECT-LPI fusion during radiotherapy planning, and most of patients, perfusion defects were patchy and non-uniform, so it was usually not possible to find beam directions that can adequately avoid the functioning tissue and deliver dose through the non-functioning tissue. This study implied more obvious reduction in FL V20 with the simple NFL than multiple NFL.…”

Section: Discussionmentioning

confidence: 99%

Spect-guidance to Reduce Radioactive Dose to Functioning Lung for Stage III Non-small Cell Lung Cancer

Wang

Wei²,

Ding³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Objective: To investigate the treatment effect of additional information obtained by single photon emission computed tomography (SPECT) lung perfusion imaging (LPI) in the radiotherapy planning process for patients with stage III non-small cell lung cancer (NSCLC). Methods: 39 patients with stage III NSCLC were enrolled. Gross tumor volume (GTV) was outlined by SPECT/CT images, SPECT-LPIs being used to define functional lung (FL) and non-functional lung (NFL) regions. Two sets of IMRT plans were designed to deliver 64Gy to PTV. One was a regular IMRT plan using CT images only (Plan 1), and the other was a corresponding IMRT plan using co-registered images (Plan 2

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Section: Discussionmentioning

confidence: 99%

Spect-guidance to Reduce Radioactive Dose to Functioning Lung for Stage III Non-small Cell Lung Cancer

Wang

Wei²,

Ding³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Ventilation and perfusion (V/Q) scans are sometimes used to determine if a patient is suitable for surgical resection and can provide information that is valuable for distinguishing high functioning from low functioning lung. V/Q SPECT data indicate that ventilation and perfusion defects are greater in central then in peripheral tumors (17). Moreover, apparently normal areas of lung on CT often have impaired function as measured by V/Q SPECT (18).…”

Section: Baseline Evaluation Of Normal Tissuesmentioning

confidence: 99%

Anatomic, functional and molecular imaging in lung cancer precision radiation therapy: treatment response assessment and radiation therapy personalization

MacManus

Everitt

Schimek-Jasch

et al. 2017

Transl. Lung Cancer Res.

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This article reviews key imaging modalities for lung cancer patients treated with radiation therapy (RT) and considers their actual or potential contributions to critical decision-making. An international group of researchers with expertise in imaging in lung cancer patients treated with RT considered the relevant literature on modalities, including computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). These perspectives were coordinated to summarize the current status of imaging in lung cancer and flag developments with future implications.Although there are no useful randomized trials of different imaging modalities in lung cancer, multiple prospective studies indicate that management decisions are frequently impacted by the use of complementary imaging modalities, leading both to more appropriate treatments and better outcomes. This is especially true of 18 F-fluoro-deoxyglucose (FDG)-PET/CT which is widely accepted to be the standard imaging modality for staging of lung cancer patients, for selection for potentially curative RT and for treatment planning. PET is also more accurate than CT for predicting survival after RT. PET imaging during RT is also correlated with survival and makes response-adapted therapies possible. PET tracers other than FDG have potential for imaging important biological process in tumors, including hypoxia and proliferation. MRI has superior accuracy in soft tissue imaging and the MRI Linac is a rapidly developing technology with great potential for online monitoring and modification of treatment. The role of imaging in RT-treated lung cancer patients is evolving rapidly and will allow increasing personalization of therapy according to the biology of both the tumor and dose limiting normal tissues.

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“…Tumor-related functional defects are often reversible through radiation (15). Because functionally defective regions are more resistant to radiation damage, functional lung dose-volume histograms (fDVHs) based on SPECT may be more accurate in predicting radiation lung toxicity than DVH models based on pretreatment CT. We have demonstrated that lung cancer patients often have multiple defects on V or Q SPECT at baseline and that such defects change during radiation (16). However, the significance on lung dosimetry is not clear.…”

Section: Introductionmentioning

confidence: 99%

Changes in Functional Lung Regions During the Course of Radiation Therapy and Their Potential Impact on Lung Dosimetry for Non-Small Cell Lung Cancer

Meng

Frey

Matuszak

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Purpose To study changes in functional activity on ventilation (V)/perfusion (Q) single-photon emission computed tomography (SPECT) during radiation therapy (RT) and explore the impact of such changes on lung dosimetry in patients with non-small cell lung cancer (NSCLC). Methods and Materials Fifteen NSCLC patients with centrally located tumors were enrolled. All patients were treated with definitive RT dose of ≥60 Gy. V/Q SPECTCT scans were performed prior to and after delivery of 45 Gy of fractionated RT. SPECT images were used to define temporarily dysfunctional regions of lung caused by tumor or other potentially reversible conditions as B3. The functional lung (FL) was defined on SPECT by 2 separate approaches: FL1, a threshold of 30% of the maximum uptake of the patient’s lung; and FL2, FL1 plus B3 region. The impact of changes in FL between initiation of RT and delivery of 45 Gy on lung dosimetry were analyzed. Results Fourteen patients (93%) had larger FL2 volumes than FL1 pre-RT (P<.001). Dysfunctional lung became functional in 11 patients (73%) on V SPECT and in 10 patients (67%) on Q SPECT. The dosimetric parameters generated from CT-based anatomical lung had significantly lower values in FL1 than FL2, with a median reduction in the volume of lung receiving a dose of at least 20 Gy (V20) of 3%, 5.6%, and mean lung dose of 0.95 and 1.55 on V and Q SPECT respectively. Conclusions Regional ventilation and perfusion function improve significantly during RT in centrally located NSCLC. Lung dosimetry values vary notably between different definitions of functional lung.

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Semiquantification and Classification of Local Pulmonary Function by V/Q Single Photon Emission Computed Tomography in Patients with Non-small Cell Lung Cancer: Potential Indication for Radiotherapy Planning

Cited by 39 publications

References 18 publications

Spect-guidance to Reduce Radioactive Dose to Functioning Lung for Stage III Non-small Cell Lung Cancer

Spect-guidance to Reduce Radioactive Dose to Functioning Lung for Stage III Non-small Cell Lung Cancer

Anatomic, functional and molecular imaging in lung cancer precision radiation therapy: treatment response assessment and radiation therapy personalization

Changes in Functional Lung Regions During the Course of Radiation Therapy and Their Potential Impact on Lung Dosimetry for Non-Small Cell Lung Cancer

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