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Title: Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy

Abstract

Purpose: The development of clinical trials is underway to use 4-dimensional computed tomography (4DCT) ventilation imaging to preferentially spare functional lung in patients undergoing radiation therapy. The purpose of this work was to generate data to aide with clinical trial design by retrospectively characterizing dosimetric and functional profiles for patients with different stages of lung cancer. Methods and Materials: A total of 118 lung cancer patients (36% stage I and 64% stage III) from 2 institutions were used for the study. A 4DCT-ventilation map was calculated using the patient's 4DCT imaging, deformable image registration, and a density-change–based algorithm. To assess each patient's spatial ventilation profile both quantitative and qualitative metrics were developed, including an observer-based defect observation and metrics based on the ventilation in each lung third. For each patient we used the clinical doses to calculate functionally weighted mean lung doses and metrics that assessed the interplay between the spatial location of the dose and high-functioning lung. Results: Both qualitative and quantitative metrics revealed a significant difference in functional profiles between the 2 stage groups (P<.01). We determined that 65% of stage III and 28% of stage I patients had ventilation defects. Average functionally weighted mean lung dose wasmore » 19.6 Gy and 5.4 Gy for stage III and I patients, respectively, with both groups containing patients with large spatial overlap between dose and high-function regions. Conclusion: Our 118-patient retrospective study found that 65% of stage III patients have regionally variant ventilation profiles that are suitable for functional avoidance. Our results suggest that regardless of disease stage, it is possible to have unique spatial interplay between dose and high-functional lung, highlighting the importance of evaluating the function of each patient and developing a personalized functional avoidance treatment approach.« less

Authors:
 [1]; ; ;  [1];  [2];  [3]; ;  [4]; ; ; ;  [1]
  1. Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)
  2. Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado (United States)
  3. Department of Radiation Oncology, University of Texas Medical Branch, Galveston, Texas (United States)
  4. Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States)
Publication Date:
OSTI Identifier:
22648746
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 95; Journal Issue: 4; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AVOIDANCE; BIOMEDICAL RADIOGRAPHY; CLINICAL TRIALS; COMPUTERIZED TOMOGRAPHY; GY RANGE 01-10; GY RANGE 10-100; IMAGES; LUNGS; METRICS; NEOPLASMS; PATIENTS; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu, Schubert, Leah, Diot, Quentin, Waxweiller, Timothy, Koo, Phillip, Castillo, Richard, Castillo, Edward, Guerrero, Thomas, Rusthoven, Chad, Gaspar, Laurie, Kavanagh, Brian, and Miften, Moyed. Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.02.058.
Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu, Schubert, Leah, Diot, Quentin, Waxweiller, Timothy, Koo, Phillip, Castillo, Richard, Castillo, Edward, Guerrero, Thomas, Rusthoven, Chad, Gaspar, Laurie, Kavanagh, Brian, & Miften, Moyed. Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy. United States. doi:10.1016/J.IJROBP.2016.02.058.
Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu, Schubert, Leah, Diot, Quentin, Waxweiller, Timothy, Koo, Phillip, Castillo, Richard, Castillo, Edward, Guerrero, Thomas, Rusthoven, Chad, Gaspar, Laurie, Kavanagh, Brian, and Miften, Moyed. Fri . "Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy". United States. doi:10.1016/J.IJROBP.2016.02.058.
@article{osti_22648746,
title = {Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy},
author = {Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu and Schubert, Leah and Diot, Quentin and Waxweiller, Timothy and Koo, Phillip and Castillo, Richard and Castillo, Edward and Guerrero, Thomas and Rusthoven, Chad and Gaspar, Laurie and Kavanagh, Brian and Miften, Moyed},
abstractNote = {Purpose: The development of clinical trials is underway to use 4-dimensional computed tomography (4DCT) ventilation imaging to preferentially spare functional lung in patients undergoing radiation therapy. The purpose of this work was to generate data to aide with clinical trial design by retrospectively characterizing dosimetric and functional profiles for patients with different stages of lung cancer. Methods and Materials: A total of 118 lung cancer patients (36% stage I and 64% stage III) from 2 institutions were used for the study. A 4DCT-ventilation map was calculated using the patient's 4DCT imaging, deformable image registration, and a density-change–based algorithm. To assess each patient's spatial ventilation profile both quantitative and qualitative metrics were developed, including an observer-based defect observation and metrics based on the ventilation in each lung third. For each patient we used the clinical doses to calculate functionally weighted mean lung doses and metrics that assessed the interplay between the spatial location of the dose and high-functioning lung. Results: Both qualitative and quantitative metrics revealed a significant difference in functional profiles between the 2 stage groups (P<.01). We determined that 65% of stage III and 28% of stage I patients had ventilation defects. Average functionally weighted mean lung dose was 19.6 Gy and 5.4 Gy for stage III and I patients, respectively, with both groups containing patients with large spatial overlap between dose and high-function regions. Conclusion: Our 118-patient retrospective study found that 65% of stage III patients have regionally variant ventilation profiles that are suitable for functional avoidance. Our results suggest that regardless of disease stage, it is possible to have unique spatial interplay between dose and high-functional lung, highlighting the importance of evaluating the function of each patient and developing a personalized functional avoidance treatment approach.},
doi = {10.1016/J.IJROBP.2016.02.058},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 95,
place = {United States},
year = {Fri Jul 15 00:00:00 EDT 2016},
month = {Fri Jul 15 00:00:00 EDT 2016}
}