SU-C-207A-07: Cumulative 18F-FDG Uptake Histogram Relative to Radiation Dose Volume Histogram of Lung After IMRT Or PSPT and Their Association with Radiation Pneumonitis

Journal Article · Wed Jun 15 04:00:00 EDT 2016 · Medical Physics

DOI:https://doi.org/10.1118/1.4955582· OSTI ID:22624342

Shusharina, N; Choi, N; Bortfeld, T ^[1]; Liao, Z; Mohan, R ^[2]

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1. Massachusetts General Hospital, Boston, MA (United States)
2. UT MD Anderson Cancer Center, Houston, TX (United States)

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.

• OSTI ID: 22624342
• Journal Information: Medical Physics, Journal Name: Medical Physics Journal Issue: 6 Vol. 43; ISSN 0094-2405; ISSN MPHYA6
• Country of Publication: United States
• Language: English

Related Subjects

60 APPLIED LIFE SCIENCES
61 RADIATION PROTECTION AND DOSIMETRY
BIOMEDICAL RADIOGRAPHY
FLUORINE 18
IMAGES
LUNGS
PATIENTS
PLANNING
PNEUMONITIS
POSITRON COMPUTED TOMOGRAPHY
RADIATION DOSES
RADIOTHERAPY
SYMPTOMS
UPTAKE