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Author Shusharina, N. ♦ Choi, N. ♦ Bortfeld, T. ♦ Liao, Z. ♦ Mohan, R.
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword APPLIED LIFE SCIENCES ♦ RADIATION PROTECTION AND DOSIMETRY ♦ BIOMEDICAL RADIOGRAPHY ♦ FLUORINE 18 ♦ IMAGES ♦ LUNGS ♦ PATIENTS ♦ PLANNING ♦ PNEUMONITIS ♦ POSITRON COMPUTED TOMOGRAPHY ♦ RADIATION DOSES ♦ RADIOTHERAPY ♦ SYMPTOMS ♦ UPTAKE
Abstract Purpose: To determine whether the difference in cumulative 18F-FDG uptake histogram of lung treated with either IMRT or PSPT is associated with radiation pneumonitis (RP) in patients with inoperable stage II and III NSCLC. Methods: We analyzed 24 patients from a prospective randomized trial to compare IMRT (n=12) with vs. PSPT (n=12) for inoperable NSCLC. All patients underwent PET-CT imaging between 35 and 88 days post-therapy. Post-treatment PET-CT was aligned with planning 4D CT to establish a voxel-to-voxel correspondence between post-treatment PET and planning dose images. 18F-FDG uptake as a function of radiation dose to normal lung was obtained for each patient. Distribution of the standard uptake value (SUV) was analyzed using a volume histogram method. The image quantitative characteristics and DVH measures were correlated with clinical symptoms of pneumonitis. Results: Patients with RP were present in both groups: 5 in the IMRT and 6 in the PSPT. The analysis of cumulative SUV histograms showed significantly higher relative volumes of the normal lung having higher SUV uptake in the PSPT patients for both symptomatic and asymptomatic cases (VSUV=2: 10% for IMRT vs 16% for proton RT and VSUV=1: 10% for IMRT vs 23% for proton RT). In addition, the SUV histograms for symptomatic cases in PSPT patients exhibited a significantly longer tail at the highest SUV. The absolute volume of the lung receiving the dose >70 Gy was larger in the PSPT patients. Conclusion: 18F-FDG uptake – radiation dose response correlates with RP in both groups of patients by means of the linear regression slope. SUV is higher for the PSPT patients for both symptomatic and asymptomatic cases. Higher uptake after PSPT patients is explained by larger volumes of the lung receiving high radiation dose.
ISSN 00942405
Educational Use Research
Learning Resource Type Article
Publisher Date 2016-06-15
Publisher Place United States
Journal Medical Physics
Volume Number 43
Issue Number 6


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