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

Wang, Zhongtang; Wei, Lili; Ding, Xuanfeng; Sun, Mingxia; Sun, Hongfu; Li, Baosheng

doi:10.7314/apjcp.2013.14.2.1061

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Shioyama et al showed that the median reductions of MLD were 2.2 Gy (17.6-14.5) and 4.2 Gy (16.0-11.8) by functional plans incorporating 50% and 90% thresholds with perfusion SPECT/CT, respectively, compared with those in the anatomic plans 19 . The other studies showed similar results 21,23,24 .…”

Section: Discussionsupporting

confidence: 72%

“…Among the 13 studies using SPECT, only three mentioned the scanning protocols including projections, acquisition times, and matrix sizes 3 , 15 , 16 . Five studies described inadequate scanning information 17 – 20 , and the remaining five, including two conference papers, did not mention any information 4 , 21 – 23 . The two studies using PET provided detailed information 24 , 25 .…”

Section: Resultsmentioning

confidence: 99%

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Single photon emission computed tomography (SPECT) or positron emission tomography (PET) imaging for radiotherapy planning in patients with lung cancer: a meta-analysis

Lee

Park

2020

Sci Rep

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Functional imaging modalities enable practitioners to identify functional lung regions. This analysis evaluated the feasibility of nuclear medicine imaging to avoid doses to the functional lung in radiotherapy (RT) planning for patients with lung cancer. This systematic review and meta-analysis was carried out according to PRISMA-P guidelines. A search of EMBASE and PubMed for studies published throughout the last 20 years was performed using the following search criteria: (a) ‘lung cancer’ or ‘lung malignancy’ and (b) ‘radiotherapy’ or ‘radiation therapy’ or ‘RT planning’ and (c) ‘SPECT’ or ‘single positron emission computed tomography’ or ‘functional image.’ The analyzed planning parameters were the volumes of the normal lung that have received ≥ 10 Gy and ≥ 20 Gy of radiation (V10 and V20, respectively) and the mean lung dose (MLD). We compared the planning parameters obtained from anatomical RT planning and functional RT planning using perfusion or ventilation imaging (‘V10, V20 or MLD’ in anatomical plan vs. ‘fV10, fV20 or fMLD’ in functional plan). A total of 309 patients with 344 RT plan sets from 15 publications (11 perfusion SPECT, 2 ventilation SPECT, and 1 SPECT and 1 PET with both perfusion and ventilation) were included in the meta-analysis. The standard mean differences in planning parameters in functional plans using nuclear imaging were significantly reduced compared to those of anatomical plans (P < 0.01 for all): − 0.42 (95% confidence interval (CI) − 0.78 to − 0.07) for ‘V10 vs. fV10′, − 0.41 (95% CI − 0.64 to − 0.17) for ‘V20 vs. fV20′, and − 0.24 (95% CI − 0.45 to − 0.03) for ‘MLD vs. fMLD’. In subgroup analysis, the functional plan using perfusion was significantly lower than the anatomical plan in all planning parameters, but there was no significant difference for ventilation. RT planning with nuclear functional lung imaging has potential to reduce radiation-induced lung injury. Perfusion imaging seems to be more promising than ventilation imaging for all planning parameters. There were not enough studies using ventilation imaging to determine what the effect is on the lung plan parameters.

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