The utility of SPECT lung perfusion scans in minimizing and assessing the physiologic consequences of thoracic irradiation

Marks, Lawrence B.; Spencer, David P.; Bentel, Gunilla C.; Ray, Shuvanan; Sherouse, George W.; Sontag, Marc R.; Coleman, R. Edward; Jaszczak, R.J.; Turkington, T.G.; Tapson, Victor F.; Prosnitz, Leonard R.

doi:10.1016/0360-3016(93)90285-4

Cited by 136 publications

(65 citation statements)

References 42 publications

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“…MR perfusion imaging of the lung can be performed within a short time, can be repeated, and may play a role as a diagnostic or investigation tool in the study of perfusion heterogeneity under various pathologic conditions such as pulmonary embolism, interstitial lung diseases, pulmonary hypertension, chronic obstructive pulmonary disease, emphysema before lung reduction therapy; in patients with mechanical ventilation, respiratory distress syndrome, after unilateral lung transplantation, or for radiation planning (17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

Demonstration of gravity-dependent lung perfusion with contrast-enhanced magnetic resonance imaging

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Chen

Levin

et al. 1999

J. Magn. Reson. Imaging

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Section: Discussionmentioning

confidence: 99%

Demonstration of gravity-dependent lung perfusion with contrast-enhanced magnetic resonance imaging

Stock

Chen

Levin

et al. 1999

J. Magn. Reson. Imaging

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“…3D dose distributions were calculated using tissue inhomogeneity corrections [24][25][26][27]. Lung contours were defined using an automatic threshold method and edited as appropriate to exclude the gross tumor and the bronchus [3].…”

Section: Clinical Evaluation Treatment Planning and Follow-upmentioning

confidence: 99%

Does transforming growth factor-β1 predict for radiation-induced pneumonitis in patients treated for lung cancer?

et al. 2006

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The purpose of the study was to reassess the utility of transforming growth factor-beta-1 (TGF-β1) together with dosimetric and tumor parameters as a predictor for radiation pneumonitis (RP). Of the 121 patients studied, 32 (26.4%) developed grade ≥ 1 RP, and 27 (22.3%) developed grade ≥ 2 RP. For the endpoint of grade ≥ 1 RP, those with V30 > 30% and an end-RT/baseline TGF-β1 ratio ≥ 1 had a significantly higher incidence of RP than did those with V30 > 30% and an end-RT/baseline TGF-β1 ratio < 1. For most other patient groups, there were no clear associations between TGF-β1 values and rates of RP. These findings suggest that TGF-β1 is generally not predictive for RP except for the group of patients with a high V30.

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“…Ventilation maps can also be derived from 4D CT imaging, in which voxel Hounsfield units correlate with the fraction of air in the voxel volume (74). In SPECT, 99m Tc-labeled macroaggregated albumin can also be used to create 3D ventilation maps (75). The feasibility of incorporating lung ventilation maps into treatment planning for conformal avoidance has been demonstrated (76).…”

Section: Normal-tissue Sensitivitymentioning

confidence: 99%

“…In lung cancer, normal-tissue response assessment has focused mainly on detection of radiation-induced lung toxicity and inflammation. The mainstay of imaging for detection of radiationinduced lung toxicity remains SPECT perfusion and ventilation for evaluating pulmonary function (75,(136)(137)(138). 18 F-FDG PET and DCE MRI have also been investigated for imaging radiation-induced lung toxicity (137,138).…”

Section: Normal-tissue Response Evaluationmentioning

confidence: 99%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

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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 ...

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The utility of SPECT lung perfusion scans in minimizing and assessing the physiologic consequences of thoracic irradiation

Cited by 136 publications

References 42 publications

Demonstration of gravity-dependent lung perfusion with contrast-enhanced magnetic resonance imaging

Demonstration of gravity-dependent lung perfusion with contrast-enhanced magnetic resonance imaging

Does transforming growth factor-β1 predict for radiation-induced pneumonitis in patients treated for lung cancer?

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

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