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Title: Radiation Pneumonitis: Local Dose Versus [{sup 18}F]-Fluorodeoxyglucose Uptake Response in Irradiated Lung

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
 [1];  [2];  [1];  [3];  [1];  [1];  [1];  [4];  [5];  [1]
  1. Division of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
  2. Department of Biostatistics and Applied Mathematics, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
  3. Department of Imaging Physics, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
  4. Department of Gastrointestinal Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
  5. Division of Radiation Oncology, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL (United States)

Purpose: To quantify the relationship between the local radiation dose received and the posttreatment positron emission tomography/computed tomography (PET/CT) [{sup 18}F]2-fluoro-2-deoxyglucose (FDG) uptake in the lung. Methods and Materials: The data from 36 patients treated for esophageal cancer with thoracic radiotherapy who underwent restaging PET/CT imaging between 4 and 12 weeks after radiotherapy completion were evaluated. Their treatment planning CT was registered with the restaging PET/CT. Using histogram analysis, the voxel average FDG-PET uptake vs. radiation dose was obtained for each case. Hierarchical linear regression models for each patient were applied to study the variation in the linear trends between cases. Deviation of the dose-response curve from a linear model was tested. Results: The median time between radiotherapy completion and FDG-PET imaging was 40 days (range, 26-70 days). The median of the mean standard uptake value in the lung that received 0-5 Gy was 0.63 (range, 0.36-1.27), 5-10 Gy was 0.77 (range, 0.40-1.35), 10-20 Gy was 0.80 (range, 0.40-1.72), and >20 Gy was 1.08 (range, 0.44-2.63). A hierarchical linear regression model of the radiation dose and normalized FDG uptake per case found an adequate fit with the linear model, and the addition of quadratic and logarithmic functions did not improve the fit. The 36 cases had a posterior mean of slopes range of 0.0048-0.069. Conclusion: The regional dose vs. radiation pneumonitis response was evaluated with FDG-PET/CT imaging. Statistical modeling found a linear relationship. The slope of this relationship varied over an order of magnitude, reflecting the range of the underlying biological response to radiation among the study population.

OSTI ID:
20953552
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Vol. 68, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2007.01.031; PII: S0360-3016(07)00142-3; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
Country of Publication:
United States
Language:
English