ArticleCancers2023
New Automated Method for Lung Functional Volumes Delineation with Lung Perfusion PET/CT Imaging.
Article in Cancers, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- A novel method for generating a fused ventilation-perfusion map using CT-derived ventilation and FDG-PET for lung functional avoidance in radiotherapy: A feasibility study.Precision radiation oncology · 2026Article
- Prediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CT.Radiation oncology (London, England) · 2025Article
- Pulmonary uptake value (PUV): a new quantification method for lung PET/CT imaging.EJNMMI research · 2025Article
- Role of functional mapping on Gallium-68 perfusion positron emission tomography and computed tomographic imaging (PET/CT) to assess the risk of long-term radiation-induced lung toxicity after stereotactic body radiation therapy.Physics and imaging in radiation oncology · 2025Article
- A review on functional lung avoidance radiotherapy plan for lung cancer.Frontiers in oncology · 2024Review
- Optimisation of the air fraction correction for lung PET/CT: addressing resolution mismatch.EJNMMI physics · 2023Article
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGallium-68 lung perfusion PET/CT is an emerging imaging modality for the assessment of regional lung function, especially to optimise radiotherapy (RT) planning. A key step of lung functional avoidance RT is the delineation of lung functional volumes (LFVs) to be integrated into radiation plans. However, there is currently no consistent and reproducible delineation method for LFVs. The aim of this study was to develop and evaluate an automated delineation threshold method based on total lung function for LFVs delineation with Gallium-68 MAA lung PET/CT imaging. MATERIAL AND
methodPatients prospectively enrolled in the PEGASUS trial-a pilot study assessing the feasibility of lung functional avoidance using perfusion PET/CT imaging for lung stereotactic body radiotherapy (SBRT) of primary or secondary lesion-were analysed. Patients underwent lung perfusion MAA-68Ga PET/CT imaging and pulmonary function tests (PFTs) as part of pre-treatment evaluation. LFVs were delineated using two methods: the commonly used relative to the maximal pixel value threshold method (pmax threshold method, X%pmax volumes) and a new approach based on a relative to whole lung function threshold method (WLF threshold method, FVX% volumes) using a dedicated iterative algorithm. For both methods, LFVs were expressed in terms of % of the anatomical lung volume (AV) and of % of the total lung activity. Functional volumes were compared for patients with normal PFTs and pre-existing airway disease.
results60 patients were analysed. Among the 48 patients who had PFTs, 31 (65%) had pre-existing lung disease. The pmax and WLF threshold methods clearly provided different functional volumes with a wide range of relative lung function for a given pmax volume, and conversely, a wide range of corresponding pmax values for a given WLF volume. The WLF threshold method provided more reliable and consistent volumes with much lower dispersion of LFVs as compared to the pmax method, especially in patients with normal PFTs.
conclusionsWe developed a relative to whole lung function threshold segmentation method to delineate lung functional volumes on perfusion PET/CT imaging. The automated algorithm allows for reproducible contouring. This new approach, relatively unaffected by the presence of hot spots, provides reliable and consistent functional volumes, and is clinically meaningful for clinicians.
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