Variations Between Dose-Ventilation and Dose-Perfusion Metrics in Radiation Therapy Planning for Lung Cancer
Purpose: Currently, several active clinical trials of functional lung avoidance radiation therapy using different imaging modalities for ventilation or perfusion are underway. Patients with lung cancer often show ventilation-perfusion mismatch, whereas the significance of dose-function metric remain...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-05-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109420300531 |
| _version_ | 1818931837512187904 |
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| author | Yujiro Nakajima, MS Noriyuki Kadoya, PhD Tomoki Kimura, MD, PhD Kazunari Hioki, MS Keiichi Jingu, MD, PhD Tokihiro Yamamoto, PhD |
| author_facet | Yujiro Nakajima, MS Noriyuki Kadoya, PhD Tomoki Kimura, MD, PhD Kazunari Hioki, MS Keiichi Jingu, MD, PhD Tokihiro Yamamoto, PhD |
| author_sort | Yujiro Nakajima, MS |
| collection | DOAJ |
| description | Purpose: Currently, several active clinical trials of functional lung avoidance radiation therapy using different imaging modalities for ventilation or perfusion are underway. Patients with lung cancer often show ventilation-perfusion mismatch, whereas the significance of dose-function metric remains unclear. The aim of the present study was to compare dose-ventilation metrics with dose-perfusion metrics for radiation therapy plan evaluation. Methods and Materials: Pretreatment 4-dimensional computed tomography and 99mTc-macroaggregated albumin single-photon emission computed tomography perfusion images of 60 patients with lung cancer treated with radiation therapy were analyzed. Ventilation images were created using the deformable image registration of 4-dimensional computed tomography image sets and image analysis for regional volume changes as a surrogate for ventilation. Ventilation and perfusion images were converted into percentile distribution images. Analyses included Pearson’s correlation coefficient and comparison of agreements between the following dose-ventilation and dose-perfusion metrics: functional mean lung dose and functional percent lung function receiving 5, 10, 20, 30, and 40 Gy (fV5, fV10, fV20, fV30, and fV40, respectively). Results: Overall, the dose-ventilation metrics were greater than the dose-perfusion metrics (ie, fV20, 26.3% ± 9.9% vs 23.9% ± 9.8%). Correlations between the dose-ventilation and dose-perfusion metrics were strong (range, r = 0.94-0.97), whereas the agreements widely varied among patients, with differences as large as 6.6 Gy for functional mean lung dose and 11.1% for fV20. Paired t test indicated that the dose-ventilation and dose-perfusion metrics were significantly different. Conclusions: Strong correlations were present between the dose-ventilation and dose-perfusion metrics. However, the agreement between the dose-ventilation and dose-perfusion metrics widely varied among patients, suggesting that ventilation-based radiation therapy plan evaluation may not be comparable to that based on perfusion. Future studies should elucidate the correlation of dose-function metrics with clinical pulmonary toxicity metrics. |
| first_indexed | 2024-12-20T04:22:56Z |
| format | Article |
| id | doaj.art-2901ca0e10e2444d8ef60de09418398f |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-12-20T04:22:56Z |
| publishDate | 2020-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-2901ca0e10e2444d8ef60de09418398f2022-12-21T19:53:35ZengElsevierAdvances in Radiation Oncology2452-10942020-05-0153459465Variations Between Dose-Ventilation and Dose-Perfusion Metrics in Radiation Therapy Planning for Lung CancerYujiro Nakajima, MS0Noriyuki Kadoya, PhD1Tomoki Kimura, MD, PhD2Kazunari Hioki, MS3Keiichi Jingu, MD, PhD4Tokihiro Yamamoto, PhD5Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan; Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan; Corresponding author: Noriyuki Kadoya, PhDDepartment of Radiation Oncology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, JapanDepartment of Clinical Support, Hiroshima University Hospital, Hiroshima, Japan; Graduate School of Health Science, Kumamoto University, Kumamoto, JapanDepartment of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Radiation Oncology, University of California Davis School of Medicine, Sacramento, CaliforniaPurpose: Currently, several active clinical trials of functional lung avoidance radiation therapy using different imaging modalities for ventilation or perfusion are underway. Patients with lung cancer often show ventilation-perfusion mismatch, whereas the significance of dose-function metric remains unclear. The aim of the present study was to compare dose-ventilation metrics with dose-perfusion metrics for radiation therapy plan evaluation. Methods and Materials: Pretreatment 4-dimensional computed tomography and 99mTc-macroaggregated albumin single-photon emission computed tomography perfusion images of 60 patients with lung cancer treated with radiation therapy were analyzed. Ventilation images were created using the deformable image registration of 4-dimensional computed tomography image sets and image analysis for regional volume changes as a surrogate for ventilation. Ventilation and perfusion images were converted into percentile distribution images. Analyses included Pearson’s correlation coefficient and comparison of agreements between the following dose-ventilation and dose-perfusion metrics: functional mean lung dose and functional percent lung function receiving 5, 10, 20, 30, and 40 Gy (fV5, fV10, fV20, fV30, and fV40, respectively). Results: Overall, the dose-ventilation metrics were greater than the dose-perfusion metrics (ie, fV20, 26.3% ± 9.9% vs 23.9% ± 9.8%). Correlations between the dose-ventilation and dose-perfusion metrics were strong (range, r = 0.94-0.97), whereas the agreements widely varied among patients, with differences as large as 6.6 Gy for functional mean lung dose and 11.1% for fV20. Paired t test indicated that the dose-ventilation and dose-perfusion metrics were significantly different. Conclusions: Strong correlations were present between the dose-ventilation and dose-perfusion metrics. However, the agreement between the dose-ventilation and dose-perfusion metrics widely varied among patients, suggesting that ventilation-based radiation therapy plan evaluation may not be comparable to that based on perfusion. Future studies should elucidate the correlation of dose-function metrics with clinical pulmonary toxicity metrics.http://www.sciencedirect.com/science/article/pii/S2452109420300531 |
| spellingShingle | Yujiro Nakajima, MS Noriyuki Kadoya, PhD Tomoki Kimura, MD, PhD Kazunari Hioki, MS Keiichi Jingu, MD, PhD Tokihiro Yamamoto, PhD Variations Between Dose-Ventilation and Dose-Perfusion Metrics in Radiation Therapy Planning for Lung Cancer Advances in Radiation Oncology |
| title | Variations Between Dose-Ventilation and Dose-Perfusion Metrics in Radiation Therapy Planning for Lung Cancer |
| title_full | Variations Between Dose-Ventilation and Dose-Perfusion Metrics in Radiation Therapy Planning for Lung Cancer |
| title_fullStr | Variations Between Dose-Ventilation and Dose-Perfusion Metrics in Radiation Therapy Planning for Lung Cancer |
| title_full_unstemmed | Variations Between Dose-Ventilation and Dose-Perfusion Metrics in Radiation Therapy Planning for Lung Cancer |
| title_short | Variations Between Dose-Ventilation and Dose-Perfusion Metrics in Radiation Therapy Planning for Lung Cancer |
| title_sort | variations between dose ventilation and dose perfusion metrics in radiation therapy planning for lung cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2452109420300531 |
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