Association Between Pulmonary Uptake of Fluorodeoxyglucose Detected by Positron Emission Tomography Scanning After Radiation Therapy for Non–Small-Cell Lung Cancer and Radiation Pneumonitis

Manus, Michael P. Mac; Ding, Zhe; Hogg, Annette; Herschtal, Alan; Binns, David; Ball, David; Hicks, Rodney J.

doi:10.1016/j.ijrobp.2010.04.021

Cited by 49 publications

(27 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although 18 F-FDG is highly specific and sensitive for imaging tumors at baseline, its specificity may be reduced in the presence of 18 F-FDG-avid radiationinduced inflammation, thereby reducing reliability of metabolic response assessment in the tumor when scans are acquired during treatment (76,77). To overcome this limitation, exploratory studies of interim tumor response monitoring have focused on other hallmarks of cancer, including rapid cellular proliferation (e.g., FLT) and hypoxia (e.g., FMISO).…”

Section: Response Assessment With Pet During Rtmentioning

confidence: 99%

“…FDG uptake in pulmonary tissue detected on PET is associated with symptoms and signs of pneumonitis and PET changes may precede symptoms (77). Esophageal toxicities have been detected via PET scans when FDG uptake was detected in the esophagus during (109) and following radiation treatment (77,(110)(111)(112)(113)(114)(115) (Figure 5A).…”

Section: Imaging Of Organs At Risk During Treatmentmentioning

confidence: 99%

“…Esophageal toxicities have been detected via PET scans when FDG uptake was detected in the esophagus during (109) and following radiation treatment (77,(110)(111)(112)(113)(114)(115) (Figure 5A). A study of 36 esophageal cancer patients identified a very congruent linear regression model connecting lung radiation dose and SUV changes (111).…”

Section: Imaging Of Organs At Risk During Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Anatomic, functional and molecular imaging in lung cancer precision radiation therapy: treatment response assessment and radiation therapy personalization

MacManus

Everitt

Schimek-Jasch

et al. 2017

Transl. Lung Cancer Res.

View full text Add to dashboard Cite

This article reviews key imaging modalities for lung cancer patients treated with radiation therapy (RT) and considers their actual or potential contributions to critical decision-making. An international group of researchers with expertise in imaging in lung cancer patients treated with RT considered the relevant literature on modalities, including computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). These perspectives were coordinated to summarize the current status of imaging in lung cancer and flag developments with future implications.Although there are no useful randomized trials of different imaging modalities in lung cancer, multiple prospective studies indicate that management decisions are frequently impacted by the use of complementary imaging modalities, leading both to more appropriate treatments and better outcomes. This is especially true of 18 F-fluoro-deoxyglucose (FDG)-PET/CT which is widely accepted to be the standard imaging modality for staging of lung cancer patients, for selection for potentially curative RT and for treatment planning. PET is also more accurate than CT for predicting survival after RT. PET imaging during RT is also correlated with survival and makes response-adapted therapies possible. PET tracers other than FDG have potential for imaging important biological process in tumors, including hypoxia and proliferation. MRI has superior accuracy in soft tissue imaging and the MRI Linac is a rapidly developing technology with great potential for online monitoring and modification of treatment. The role of imaging in RT-treated lung cancer patients is evolving rapidly and will allow increasing personalization of therapy according to the biology of both the tumor and dose limiting normal tissues.

show abstract

Section: Response Assessment With Pet During Rtmentioning

confidence: 99%

Section: Imaging Of Organs At Risk During Treatmentmentioning

confidence: 99%

Section: Imaging Of Organs At Risk During Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Anatomic, functional and molecular imaging in lung cancer precision radiation therapy: treatment response assessment and radiation therapy personalization

MacManus

Everitt

Schimek-Jasch

et al. 2017

Transl. Lung Cancer Res.

View full text Add to dashboard Cite

show abstract

“…The functional relationship between posttherapy 18 F-FDG uptake and radiation dose has been measured and shown to correlate with the clinical symptoms of radiation pneumonitis after thoracic radiotherapy (139). The intensity of posttherapy 18 F-FDG uptake was related to the severity of radiation pneumonitis using a simple visual scoring system (140). Similarly, increased 18 F-FDG uptake in normal lung was associated with the subsequent development of clinical radiation-induced lung toxicity early during radiotherapy (141).…”

Section: Normal-tissue Response Evaluationmentioning

confidence: 99%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

View full text Add to dashboard Cite

Learning Objectives: On successful completion of this activity, participants should be able to describe (1) how to acquire high-quality molecular images for use in radiation therapy; (2) how molecular imaging can be used to plan radiotherapy and evaluate treatment efficacy; and (3) the limitations and challenges to widespread use of molecular imaging in radiation oncology.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through November 2018.Molecular imaging plays a central role in the management of radiation oncology patients. Specific uses of imaging, particularly to plan radiotherapy and assess its efficacy, require an additional level of reproducibility and image quality beyond what is required for diagnostic imaging. Specific requirements include proper patient preparation, adequate technologist training, careful imaging protocol design, reliable scanner technology, reproducible software algorithms, and reliable data analysis methods. As uncertainty in target definition is arguably the greatest challenge facing radiation oncology, the greatest impact that molecular imaging can have may be in the reduction of interobserver variability in target volume delineation and in providing greater conformity between target volume boundaries and true tumor boundaries. Several automatic and semiautomatic contouring methods based on molecular imaging are available but still need sufficient validation to be widely adopted. Biologically conformal radiotherapy (dose painting) based on molecular imaging-assessed tumor heterogeneity is being investigated, but many challenges remain to fully exploring its potential. Molecular imaging also plays increasingly important roles in both early (during treatment) and late (after treatment) response assessment as both a predictive and a prognostic tool. Because of potentially confounding effects of radiation-induced inflammation, treatment response assessment requires careful interpretation. Although molecular imaging is already strongly embedded in radiotherapy, the path to widespread and all-inclusive use is still long. The lack of solid clinical evidence is the main impediment to broader use. Recommendations for practicing physicians are still rather scarce. 18 F-FDG PET/CT remains the main molecular imaging modality in radiation oncology applications. Although other molecular imaging options (e.g., proliferation imaging) are becoming more common, their widespread use is limited ...

show abstract

“…MRI was used to measure lung density [33] and asymmetric enhancement on dynamic perfusion [34], which was shown to correlate with radiation pneumonitis. Increased FDG uptake was found in lung and esophagus on PET imaging, and correlated to lung and esophageal toxicities [35][36][37][38][39][40][41]. SPECT is an imaging modality that can directly measure the lung and heart function for their perfusion and ventilation, and it has been used to measure the radiation-induced changes in lung and heart function [31,42,43].…”

Section: Imaging Normal Tissue Responsementioning

confidence: 99%

Personalized Radiation Therapy (PRT) for Lung Cancer

Jin

Kong

2015

Advances in Experimental Medicine and Biology

View full text Add to dashboard Cite

This chapter reviews and discusses approaches and strategies of personalized radiation therapy (PRT) for lung cancers at four different levels: (1) clinically established PRT based on a patient's histology, stage, tumor volume and tumor locations; (2) personalized adaptive radiation therapy (RT) based on image response during treatment; (3) PRT based on biomarkers; (4) personalized fractionation schedule. The current RT practice for lung cancer is partially individualized according to tumor histology, stage, size/location, and combination with use of systemic therapy. During-RT PET-CT image guided adaptive treatment is being tested in a multicenter trial. Treatment response detected by the during-RT images may also provide a strategy to further personalize the remaining treatment. Research on biomarker-guided PRT is ongoing. The biomarkers include genomics, proteomics, microRNA, cytokines, metabolomics from tumor and blood samples, and radiomics from PET, CT, SPECT images. Finally, RT fractionation schedule may also be personalized to each individual patient to maximize therapeutic gain. Future PRT should be based on comprehensive considerations of knowledge acquired from all these levels, as well as consideration of the societal value such as cost and effectiveness.

show abstract

Association Between Pulmonary Uptake of Fluorodeoxyglucose Detected by Positron Emission Tomography Scanning After Radiation Therapy for Non–Small-Cell Lung Cancer and Radiation Pneumonitis

Cited by 49 publications

References 24 publications

Anatomic, functional and molecular imaging in lung cancer precision radiation therapy: treatment response assessment and radiation therapy personalization

Anatomic, functional and molecular imaging in lung cancer precision radiation therapy: treatment response assessment and radiation therapy personalization

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

Personalized Radiation Therapy (PRT) for Lung Cancer

Contact Info

Product

Resources

About