Functional image-based radiotherapy planning for non-small cell lung cancer: A simulation study

Bates, E.; Bragg, C.; Wild, Jim M.; Hatton, Matthew; Ireland, R.H.

doi:10.1016/j.radonc.2009.05.018

Cited by 59 publications

(44 citation statements)

References 21 publications

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“…The feasibility of using the indirect registration technique for regional quantification of ventilation of specific pulmonary structures is demonstrated in Figure 6. In addition, registration to CT is critical in radiotherapy for the implementation of functionally weighted treatment planning (Ireland et al, 2007a;Bates et al, 2009;Partridge et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid hyperpolarized gas/¹H MRI

et al. 2014

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This is a repository copy of ReuseUnless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request.A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid Short Title Hyperpolarised gas MRI and CT image registration AbstractHyperpolarized gas MRI generates highly detailed maps of lung ventilation and physiological function while CT provides corresponding anatomical and structural information. Fusion of such complementary images enables quantitative analysis of pulmonary structure-function. However, direct image registration of hyperpolarized gas MRI to CT is problematic, particularly in lungs whose boundaries are difficult to delineate due to ventilation heterogeneity. This study presents a novel indirect method of registering hyperpolarized gas MRI to CT utilizing 1 H-structural MR images that are acquired in the same breath-hold as the gas MRI. The feasibility of using this technique for regional quantification of ventilation of specific pulmonary structures is demonstrated for the lobes.The direct and indirect methods of hyperpolarized gas MRI to CT image registration were compared using lung images from 15 asthma patients. Both affine and diffeomorphic image transformations were implemented. Registration accuracy was evaluated using the target registration error (TRE) of anatomical landmarks identified on 1 H MRI and CT. Wilcoxon signed-rank test was used to test statistical significance.For the affine transformation, the indirect method of image registration was significantly more accurate than the direct method (TRE=14.7±3.2 vs. 19.6±12.7mm, p=0.036). Using a deformable transformation, the indirect method was also more accurate than the direct method (TRE=13.5±3.3 vs. 20.4±12.8mm, p=0.006).Accurate image registration is critical for quantification of regional lung ventilation with hyperpolarized gas MRI within the anatomy delineated by CT. Automatic deformable image registration of hyperpolarized gas MRI to CT via same breath-hold 1 H MRI is more accurate than direct registration. Potential applications include improved multi-modality image fusion, functionally-weighted radiotherapy planning, and quantification of lobar ventilation in obstructive airways disease.

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Section: Discussionmentioning

confidence: 99%

A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid hyperpolarized gas/¹H MRI

et al. 2014

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“…To reduce the risk of RP in patients with PE, several authors have reported on functional imaging modalities such as four-dimensional CT [19], single-photon emission CT [20] and functional MRI [21]. For example, Bates et al [21] suggested that reductions in the V20 for functional lung are possible for a subset of patients with locally advanced NSCLC when standard IMRT planning techniques are supplemented by simulated functional lung imaging information to reduce the risk of RP.…”

Section: Risk Factors Of Radiation Pneumonitis Focused On Pulmonary Ementioning

confidence: 99%

“…For example, Bates et al [21] suggested that reductions in the V20 for functional lung are possible for a subset of patients with locally advanced NSCLC when standard IMRT planning techniques are supplemented by simulated functional lung imaging information to reduce the risk of RP. However, further work will be needed to confirm such reports and to establish their clinical usefulness.…”

Section: Risk Factors Of Radiation Pneumonitis Focused On Pulmonary Ementioning

confidence: 99%

Radiation pneumonitis in patients with lung and mediastinal tumours: a retrospective study of risk factors focused on pulmonary emphysema

Kimura¹,

Togami²,

Takashima³

et al. 2012

BJR

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Objectives: To evaluate the impact of pulmonary emphysema (PE) on the incidence and severity of radiation pneumonitis (RP) in patients with lung and mediastinal tumours. Methods: 92 patients were enrolled. Involved-field radiation therapy (non-small cell carcinoma or mediastinal tumours in 69 patients; median 70 Gy) and accelerated hyperfractionation (limited disease small cell carcinoma in 23 patients; median 45 Gy) were performed. Common Terminology Criteria for Adverse Events v.3.0 was used to evaluate RP and the relationship with the percentage of pulmonary volume irradiated to .20 Gy (V20) and PE. PE was diagnosed by the presence of low-attenuation areas (LAAs) on CT scans and was classified into Grades 0-4 according to the extent of the LAAs. Results: The median follow-up time was 16 months. The 6-month cumulative incidence of RP at Grade 3 or greater was 7.7% and 34.1% in patients with a V20 of ,25% and >25%, respectively (p50.017). In patients with PE Grades 0, 1, 2 and 3 or greater, the incidence of RP was 16.5%, 9.1%, 8.6% and 54.0%, respectively. As the PE Grade increased, the incidence of RP also increased significantly. Conclusion: The incidence and severity of RP are significantly higher in patients with a high V20 value as well as in those with severe PE.

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“…Absolute reductions in functional V20 range from no significant difference [104,111] and 3-7% for SPECT [107,109,110,113,114]; no significant difference [16] and 4% for perfusion PET but no significant difference when using ventilation PET [15]; 2-3% for MRI [17,60,62]; and no significant difference [99 101,112] and 5% for CT-based methods [33,96,98,97] (Table 1). However, comparison between studies is complicated by the diverse methodology employed, including patient characteristics, planning techniques, segmentation and definition of functional regions, image registration and other image processing, and a lack of consistency in the use and reporting of statistical analysis.…”

Section: Planning Studiesmentioning

confidence: 99%

“…However, in some cases the optimisation of beam angles can eliminate significant differences between anatomical and functional plans obtained from fixed beam-only plans [98]. Interestingly, the largest functional V20 differences of 5-7% have been found when using fixed beams [96,98,109,113] in contrast to optimised beam angles which tend to produce 2-3% differences [17,60,99,107,97], although both methods have also produced a large number of cases with no significant difference due to additional functional data [5,98,100,104,105,111].…”

Section: Planning Studiesmentioning

confidence: 99%

Functional Image-guided Radiotherapy Planning for Normal Lung Avoidance

et al. 2016

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ReuseThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) licence. This licence only allows you to download this work and share it with others as long as you credit the authors, but you can't change the article in any way or use it commercially. More information and the full terms of the licence here: https://creativecommons.org/licenses/ Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. 1 AbstractFor patients with lung cancer undergoing curative intent radiotherapy, functional lung imaging can be incorporated into treatment planning to modify the dose distribution within non-target volume lung by differentiation of lung regions that are functionally defective or viable. This concept of functional image-guided lung avoidance treatment planning has been investigated with several imaging modalities, primarily SPECT but also hyperpolarised gas MRI, PET and CT-based measures of lung biomechanics. Here, we review the application of each of these modalities, review practical issues of lung avoidance implementation, including image registration and the role of both ventilation and perfusion imaging, and provide guidelines for reporting of future lung avoidance planning studies.

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Functional image-based radiotherapy planning for non-small cell lung cancer: A simulation study

Abstract: Background and purpose: To investigate the incorporation of data from single-photon emission computed tomography (SPECT) or hyperpolarized helium-3 magnetic resonance imaging ( 3 He-MRI) into intensity-modulated radiotherapy (IMRT) planning for non-small cell lung cancer (NSCLC).

Cited by 59 publications

References 21 publications

A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid hyperpolarized gas/¹H MRI

A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid hyperpolarized gas/¹H MRI

Radiation pneumonitis in patients with lung and mediastinal tumours: a retrospective study of risk factors focused on pulmonary emphysema

Functional Image-guided Radiotherapy Planning for Normal Lung Avoidance

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Functional image-based radiotherapy planning for non-small cell lung cancer: A simulation study

Abstract: Background and purpose: To investigate the incorporation of data from single-photon emission computed tomography (SPECT) or hyperpolarized helium-3 magnetic resonance imaging ( 3 He-MRI) into intensity-modulated radiotherapy (IMRT) planning for non-small cell lung cancer (NSCLC).

Cited by 59 publications

References 21 publications

A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid hyperpolarized gas/1H MRI

A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid hyperpolarized gas/1H MRI

Radiation pneumonitis in patients with lung and mediastinal tumours: a retrospective study of risk factors focused on pulmonary emphysema

Functional Image-guided Radiotherapy Planning for Normal Lung Avoidance

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A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid hyperpolarized gas/¹H MRI

A method for quantitative analysis of regional lung ventilation using deformable image registration of CT and hybrid hyperpolarized gas/¹H MRI