ArticlePhysics and imaging in radiation oncology2025
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.
Article in Physics and imaging in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and purpose: To compare the performance of anatomic and functional dosimetric parameters based on Gallium-68 lung perfusion positron emission tomography and computed tomographic imaging (PET/CT) imaging to predict the risk of symptomatic long-term radiation-induced lung toxicity (RILT) in patients with lung tumors treated with stereotactic body radiation therapy (SBRT). Materials and methods: We have performed a prospective study in patients treated with SBRT. Mean dose (MD) and volumes receiving xGy were calculated in five lung volumes: the conventional anatomical volume (AV) delineated on CT images, three lung functional volumes defined on lung perfusion PET imaging (FV50%, FV70%, FV90%, i.e. the minimal volume containing 50 %, 70 % and 90 % of the total activity within the AV), and a low functional volume (LFV = AV-FV90%). The primary endpoint of this analysis was grade ≥2 long-term RILT at 12 months as assessed with NCI CTCAE v.5. The predictive value of anatomical and functional dose volume parameters was evaluated by comparing patients with and without long-term RILT. Results: Out of the 59 patients included, 50 were still alive at 12 months and 9 (18 %) had grade ≥2 long-term RILT. The MD and the VxGy in the AV and LFV were not statistically different in patients with and without long-term RILT (p > 0.05). All functional parameters in FV50% and FV70% were significantly higher in long-term RILT patients (p < 0.05). Discussion: The predictive value of PET perfusion-based functional parameters outperforms the standard CT-based dose-volume parameters for the risk of grade ≥2 long-term RILT.
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