ArticleInternational journal of radiation oncology, biology, physics2017
Evaluating the Toxicity Reduction With Computed Tomographic Ventilation Functional Avoidance Radiation Therapy.
Article in International journal of radiation oncology, biology, physics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Incorporation of Functional Lung Imaging Into Radiation Therapy Planning in Patients With Lung Cancer: A Systematic Review and Meta-Analysis.International journal of radiation oncology, biology, physics · 2024Pooled it
- Patient-Reported Outcomes: Comparing Functional Avoidance and Standard Thoracic Radiation Therapy in Lung Cancer.JCO clinical cancer informatics · 2025Trial
- Prospective Trial of Functional Lung Avoidance Radiation Therapy for Lung Cancer: Quality of Life Report.International journal of radiation oncology, biology, physics · 2024Trial
- Evaluation of variables predicting PFT changes for lung cancer patients treated on a prospective 4DCT-ventilation functional avoidance clinical trial.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2023Trial
- Results of a Multi-Institutional Phase 2 Clinical Trial for 4DCT-Ventilation Functional Avoidance Thoracic Radiation Therapy.International journal of radiation oncology, biology, physics · 2022Trial
- Interim Analysis of a Two-Institution, Prospective Clinical Trial of 4DCT-Ventilation-based Functional Avoidance Radiation Therapy.International journal of radiation oncology, biology, physics · 2018Trial
- Study protocol for the TROG 21.08 VITaL trial: a randomized controlled trial investigating ventilation imaging to improve the quality of life for patients with lung cancer treated with radiation therapy.Clinical and translational radiation oncology · 2027Article
- Predicting End-of-Treatment Ventilation Response to Radiation Therapy Using Early Treatment Ventilation for Patients With Lung Cancer Treated With Photons and Protons.International journal of radiation oncology, biology, physics · 2026Article
- Quantitative lung tissue functional analysis for pulmonary adverse event risk assessment prior to thoracic radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Simultaneous synthesis of perfusion and ventilation images from CT using a dual-decoder residual attention network for lung disease diagnosis.Journal of applied clinical medical physics · 2026Article
- Relevance between patients' clinical factors and 4D-CT lung ventilation heterogeneity for evaluating the adoption of functional avoidance thoracic radiotherapy with a large patient database.Frontiers in oncology · 2026Article
- Functional lung avoidance stereotactic body radiation therapy for central lung cancer patients.Quantitative imaging in medicine and surgery · 2025Article
- Integrating spot-scanning proton arc therapy with functional avoidance strategies to reduce pulmonary toxicity.Physics and imaging in radiation oncology · 2025Article
- Weekly changes in ventilation response for photon and proton lung cancer patients during radiotherapy.medRxiv : the preprint server for health sciences · 2025Article
- Hybrid method for estimating lung ventilation from CT by combining intensity and motion information.Medical physics · 2025Article
- Perfusion estimation from dynamic non-contrast computed tomography using self-supervised learning and a physics-inspired U-net transformer architecture.International journal of computer assisted radiology and surgery · 2025Article
- Conference Report: Review of Clinical Implementation of Advanced Quantitative Imaging Techniques for Personalized Radiotherapy.Tomography (Ann Arbor, Mich.) · 2024Article
- Quantitative texture analysis using machine learning for predicting interpretable pulmonary perfusion from non-contrast computed tomography in pulmonary embolism patients.Respiratory research · 2024Article
- Systematic Evaluation of the Impact of Lung Segmentation Methods on 4-Dimensional Computed Tomography Ventilation Imaging Using a Large Patient Database.International journal of radiation oncology, biology, physics · 2024Article
- A review on functional lung avoidance radiotherapy plan for lung cancer.Frontiers in oncology · 2024Review
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
Abstract
purposeComputed tomographic (CT) ventilation imaging is a new modality that uses 4-dimensional (4D) CT information to calculate lung ventilation. Although retrospective studies have reported on the reduction in dose to functional lung, no work to our knowledge has been published in which the dosimetric improvements have been translated to a reduction in the probability of pulmonary toxicity. Our work estimates the reduction in toxicity for CT ventilation-based functional avoidance planning. METHODS AND MATERIALS: Seventy previously treated lung cancer patients who underwent 4DCT imaging were used for the study. CT ventilation maps were calculated with 4DCT deformable image registration and a density change-based algorithm. Pneumonitis was graded on the basis of imaging and clinical presentation. Maximum likelihood methods were used to generate normal tissue complication probability (NTCP) models predicting grade 2 or higher (2+) and grade 3+ pneumonitis as a function of dose (V5 Gy, V10 Gy, V20 Gy, V30 Gy, and mean dose) to functional lung. For 30 patients a functional plan was generated with the goal of reducing dose to the functional lung while meeting Radiation Therapy Oncology Group 0617 constraints. The NTCP models were applied to the functional plans and the clinically used plans to calculate toxicity reduction.
resultsBy the use of functional avoidance planning, absolute reductions in grade 2+ NTCP of 6.3%, 7.8%, and 4.8% were achieved based on the mean fV20 Gy, fV30 Gy, and mean dose to functional lung metrics, respectively. Absolute grade 3+ NTCP reductions of 3.6%, 4.8%, and 2.4% were achieved with fV20 Gy, fV30 Gy, and mean dose to functional lung. Maximum absolute reductions of 52.3% and 16.4% were seen for grade 2+ and grade 3+ pneumonitis for individual patients.
conclusionOur study quantifies the possible toxicity reduction from CT ventilation-based functional avoidance planning. Reductions in grades 2+ and 3+ pneumonitis were 7.1% and 4.7% based on mean dose-function metrics, with reductions as high as 52.3% for individual patients. Our work provides seminal data for determining the potential toxicity benefit from incorporating CT ventilation into thoracic treatment planning.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.