ArticlePloS one2018
Evaluation of lung toxicity risk with computed tomography ventilation image for thoracic cancer patients.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Quantitative lung tissue functional analysis for pulmonary adverse event risk assessment prior to thoracic radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Functional lung avoidance stereotactic body radiation therapy for central lung cancer patients.Quantitative imaging in medicine and surgery · 2025Article
- Development of a novel detection method for changes in lung conditions during radiotherapy using a temporal subtraction technique.Physical and engineering sciences in medicine · 2021Article
- Predicting radiation pneumonitis with fuzzy clustering neural network using 4DCT ventilation image based dosimetric parameters.Quantitative imaging in medicine and surgery · 2021Article
- Feasibility of function-guided lung treatment planning with parametric response mapping.Journal of applied clinical medical physics · 2021Article
- Stereotactic body radiotherapy in patients with chronic obstructive pulmonary disease and interstitial pneumonia: a review.International journal of clinical oncology · 2019Review
- Investigating the SPECT Dose-Function Metrics Associated With Radiation-Induced Lung Toxicity Risk in Patients With Non-small Cell Lung Cancer Undergoing Radiation Therapy.Advances in radiation oncologyArticle
- Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFour-dimensional computed tomography (4D-CT) ventilation is an emerging imaging modality. Functional avoidance of regions according to 4D-CT ventilation may reduce lung toxicity after radiation therapy. This study evaluated associations between 4D-CT ventilation-based dosimetric parameters and clinical outcomes.
methodsPre-treatment 4D-CT data were used to retrospectively construct ventilation images for 40 thoracic cancer patients retrospectively. Fifteen patients were treated with conventional radiation therapy, 6 patients with hyperfractionated radiation therapy and 19 patients with stereotactic body radiation therapy (SBRT). Ventilation images were calculated from 4D-CT data using a deformable image registration and Jacobian-based algorithm. Each ventilation map was normalized by converting it to percentile images. Ventilation-based dosimetric parameters (Mean Dose, V5 [percent lung volume receiving ≥5 Gy], and V20 [percent lung volume receiving ≥20 Gy]) were calculated for highly and poorly ventilated regions. To test whether the ventilation-based dosimetric parameters could be used predict radiation pneumonitis of ≥Grade 2, the area under the curve (AUC) was determined from the receiver operating characteristic analysis.
resultsFor Mean Dose, poorly ventilated lung regions in the 0-30% range showed the highest AUC value (0.809; 95% confidence interval [CI], 0.663-0.955). For V20, poorly ventilated lung regions in the 0-20% range had the highest AUC value (0.774; 95% [CI], 0.598-0.915), and for V5, poorly ventilated lung regions in the 0-30% range had the highest AUC value (0.843; 95% [CI], 0.732-0.954). The highest AUC values for Mean Dose, V20, and V5 were obtained in poorly ventilated regions. There were significant differences in all dosimetric parameters between radiation pneumonitis of Grade 1 and Grade ≥2.
conclusionsPoorly ventilated lung regions identified on 4D-CT had higher AUC values than highly ventilated regions, suggesting that functional planning based on poorly ventilated regions may reduce the risk of lung toxicity in radiation therapy.
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