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A new approach to quantifying lung damage after stereotactic body radiation therapy.
MedLine Citation:
PMID:  21174519     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Radiological pneumonitis and fibrosis are common after stereotactic body radiotherapy (SBRT) but current scoring systems are qualitative and subjective. We evaluated the use of CT density measurements and a deformable registration tool to quantitatively measure lung changes post-SBRT. Material and methods. Four-dimensional CT datasets from 25 patients were imported into an image analysis program. Deformable registration was done using a B-spline algorithm (VelocityAI) and evaluated by landmark matching. The effects of respiration, contrast, and CT scanner on density measurements were evaluated. The relationship between density and clinician-scored radiological pneumonitis was assessed. Results. Deformable registration resulted in more accurate image matching than rigid registration. CT lung density was maximal at end-expiration, and most deformation with breathing occurred in the lower thorax. Use of contrast increased mean lung density by 18 HU (range 16-20 HU; p = 0.004). Diagnostic scans had a lower mean lung density than planning scans (mean difference 57 HU in lung contralateral to tumor; p = 0.048). Post-treatment CT density measurements correlated strongly with clinician-scored radiological pneumonitis (r = 0.75; p < 0.001). Conclusions. Quantitative analysis of changes in lung density correlated strongly with physician-assigned radiologic pneumonitis scores. Deformable registration and CT density measurements permit objective assessment of treatment toxicity.
Authors:
David A Palma; John R van Sörnsen de Koste; Wilko F A R Verbakel; Suresh Senan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-21
Journal Detail:
Title:  Acta oncologica (Stockholm, Sweden)     Volume:  -     ISSN:  1651-226X     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8709065     Medline TA:  Acta Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands.
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