Radiation-Induced Reductions in Regional Lung Perfusion: 0.1-12 Year Data From a Prospective Clinical Study

Journal Article · Sun Jan 31 23:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.02.005· OSTI ID:21372056

Jinli, Ma ^[1]; Sumin, Zhou ^[2]; Hubbs, Jessica L ^[3]; Wong, Terence Z ^[4]; Folz, Rodney J ^[5]; Evans, Elizabeth S ^[1]; Jaszczak, Ronald J ^[4]; Clough, Robert ^[1]; Marks, Lawrence B ^[3]

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1. Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)
2. Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE (United States)
3. Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC (United States)
4. Department of Radiology, Duke University Medical Center, Durham, NC (United States)
5. Pulmonary, Critical Care and Sleep Disorders Medicine, University of Louisville Health Sciences Center, Louisville, KY (United States)

Purpose: To assess the time and regional dependence of radiation therapy (RT)-induced reductions in regional lung perfusion 0.1-12 years post-RT, as measured by single photon emission computed tomography (SPECT) lung perfusion. Materials/Methods: Between 1991 and 2005, 123 evaluable patients receiving RT for tumors in/around the thorax underwent SPECT lung perfusion scans before and serially post-RT (0.1-12 years). Registration of pre- and post-RT SPECT images with the treatment planning computed tomography, and hence the three-dimensional RT dose distribution, allowed changes in regional SPECT-defined perfusion to be related to regional RT dose. Post-RT follow-up scans were evaluated at multiple time points to determine the time course of RT-induced regional perfusion changes. Population dose response curves (DRC) for all patients at different time points, different regions, and subvolumes (e.g., whole lungs, cranial/caudal, ipsilateral/contralateral) were generated by combining data from multiple patients at similar follow-up times. Each DRC was fit to a linear model, and differences statistically analyzed. Results: In the overall groups, dose-dependent reductions in perfusion were seen at each time post-RT. The slope of the DRC increased over time up to 18 months post-RT, and plateaued thereafter. Regional differences in DRCs were only observed between the ipsilateral and contralateral lungs, and appeared due to tumor-associated changes in regional perfusion. Conclusions: Thoracic RT causes dose-dependent reductions in regional lung perfusion that progress up to {approx}18 months post-RT and persists thereafter. Tumor shrinkage appears to confound the observed dose-response relations. There appears to be similar dose response for healthy parts of the lungs at different locations.

• OSTI ID: 21372056
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CHEST
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DISEASES
DOSE-RESPONSE RELATIONSHIPS
EMISSION COMPUTED TOMOGRAPHY
LUNGS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
RADIATION DOSE DISTRIBUTIONS
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SHRINKAGE
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
THERAPY
THREE-DIMENSIONAL CALCULATIONS
TOMOGRAPHY