Dose-Response Relationship Between Radiation Therapy and Loss of Lung Perfusion Comparing Positron Emission Tomography and Dual-Energy Computed Tomography in Non-Small Cell Lung Cancer
Details
Publication Year 2024-03-15,Volume 118,Issue #4,Page 1135-1143
Journal Title
International Journal of Radiation Oncology, Biology, Physics
Publication Type
Research article
Abstract
PURPOSE: Radiation therapy treatment for non-small cell lung cancer (NSCLC) may result in radiation damage to the perfused lung. The loss in perfusion may be measured from positron tomography emission (PET) perfusion imaging; however, this modality may not be widely available. Dual-energy computed tomography (DECT) with contrast may be an alternative to PET/CT. The purpose of this work is to investigate the equivalence of dose-response curves (DRCs) determined from PET and DECT in NSCLC. METHODS AND MATERIALS: PET and DECT data sets from the prospective clinical trial HI-FIVE (NTC03569072) were included in this preplanned trial analysis. Patients underwent (68)Ga-macroaggregated albumin PET/CT examination and DECT with contrast on the same day at baseline and at 3 and 12 months after treatment. The perfused lung was defined from a threshold based on the maximum standardized uptake value (%SUVmax)/iodine concentration (%IoMax) in PET/DECT. The equivalence between PET and DECT DRC was established by comparing (1) the average of the normalized overlap of the 2 DRCs ranging from 0 (no overlap) to 1 (perfect overlap) and (2) the slope of a linear model applied to DRCs. RESULTS: Of the 19 patients enrolled in the clinical trial, 14/10 patients had a posttreatment imaging session at a median of 4.5/13.5 months, respectively. With 30%SUVmax/35%IoMax, the average normalized overlap was maximized, and the difference between PET and DECT slopes of the linear model was minimized at each time point (slope = 0.76%/Gy / 0.75%/Gy at 3 months and 0.86%/Gy / 0.87%/Gy at 12 months determined from PET/DECT). CONCLUSIONS: The dose-response relationship determined from DECT was comparable to that from PET at 3 and 12 months after treatment in patients with NSCLC.
Publisher
Elsevier
Keywords
Humans; *Carcinoma, Non-Small-Cell Lung/diagnostic imaging/radiotherapy; *Lung Neoplasms/diagnostic imaging/radiotherapy; Positron Emission Tomography Computed Tomography; Prospective Studies; Lung/diagnostic imaging; Positron-Emission Tomography/methods; Perfusion; Fluorodeoxyglucose F18
Department(s)
Physical Sciences; Radiation Oncology; Cancer Imaging
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Creation Date: 2024-04-02 04:13:38
Last Modified: 2024-04-02 04:13:52

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