TU‐A‐WAB‐05

Using 4DCT‐Ventilation Based Multi‐Modality Imaging to Assess Lung Function and Optimize Radiation Therapy for Lung Cancer Patients

Y. Vinogradskiy, L. Schubert, R. Castillo, E. Castillo, M. Martel, T. Guerrero, M. Miften

Research output: Contribution to journalArticle

Abstract

Purpose: A new form of imaging has been developed to assess ventilation‐based lung function using 4DCT. Because 4DCTs are acquired as part of thoracic simulation, calculation of 4DCT‐ventilation maps enables exciting opportunities to assess pre‐treatment lung function and create functional avoidance radiotherapy plans. The purpose of our work was to use 4DCT‐ventilation to evaluate lung function differences between stage I and III lung cancer patients and investigate strategies to adapt plans to a patients ventilation profile. Methods: We retrospectively analyzed 40 stage I and 69 stage III lung cancer patients collected from 2 different institutions. Pre‐treatment ventilation maps were calculated using the simulation 4DCT, deformable image registration, and a density‐change based model. To assess ventilation homogeneity of stage I and III patients we studied visually observed ventilation defects, an ipsilateral/contralateral ventilation ratio, and the standard deviation (SD) of lung ventilation. Plans for both stage groups were created using ventilation‐based functional avoidance maps. The feasibility and quality of plans was assessed using dose‐volume and dose‐function metrics. Results: Fifteen percent of the stage I cohort and 33% of the stage III cohort had ventilation defects. The ipsilateral/contralateral ventilation ratio was significantly different (p=0.005) between stage I (ratio=1.06) and stage III (ratio=0.83) patients. Similarly, the SD of stage I and stage III patients was significantly different (p=0.023). Representative functional avoidance plans are presented for both stage I and III groups that improve dose sparing of functional lung. Conclusion: Patients at varying stages of lung disease have different functional profiles and require unique strategies to create functional avoidance plans. We present quantitative data to highlight the impaired lung function of advanced disease patients and explore the potential of using that functional information to adapt plans to a patients ventilation profile. Our study presents an important step of incorporating 4DCT‐based ventilation imaging into the clinic.

Original languageEnglish (US)
Number of pages1
JournalMedical Physics
Volume40
Issue number6
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Ventilation
Lung Neoplasms
Radiotherapy
Lung
Lung Diseases
Thorax

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging

Cite this

TU‐A‐WAB‐05 : Using 4DCT‐Ventilation Based Multi‐Modality Imaging to Assess Lung Function and Optimize Radiation Therapy for Lung Cancer Patients. / Vinogradskiy, Y.; Schubert, L.; Castillo, R.; Castillo, E.; Martel, M.; Guerrero, T.; Miften, M.

In: Medical Physics, Vol. 40, No. 6, 2013.

Research output: Contribution to journalArticle

Vinogradskiy, Y. ; Schubert, L. ; Castillo, R. ; Castillo, E. ; Martel, M. ; Guerrero, T. ; Miften, M. / TU‐A‐WAB‐05 : Using 4DCT‐Ventilation Based Multi‐Modality Imaging to Assess Lung Function and Optimize Radiation Therapy for Lung Cancer Patients. In: Medical Physics. 2013 ; Vol. 40, No. 6.
@article{8b056829d15e4550823af3aa39bd1802,
title = "TU‐A‐WAB‐05: Using 4DCT‐Ventilation Based Multi‐Modality Imaging to Assess Lung Function and Optimize Radiation Therapy for Lung Cancer Patients",
abstract = "Purpose: A new form of imaging has been developed to assess ventilation‐based lung function using 4DCT. Because 4DCTs are acquired as part of thoracic simulation, calculation of 4DCT‐ventilation maps enables exciting opportunities to assess pre‐treatment lung function and create functional avoidance radiotherapy plans. The purpose of our work was to use 4DCT‐ventilation to evaluate lung function differences between stage I and III lung cancer patients and investigate strategies to adapt plans to a patients ventilation profile. Methods: We retrospectively analyzed 40 stage I and 69 stage III lung cancer patients collected from 2 different institutions. Pre‐treatment ventilation maps were calculated using the simulation 4DCT, deformable image registration, and a density‐change based model. To assess ventilation homogeneity of stage I and III patients we studied visually observed ventilation defects, an ipsilateral/contralateral ventilation ratio, and the standard deviation (SD) of lung ventilation. Plans for both stage groups were created using ventilation‐based functional avoidance maps. The feasibility and quality of plans was assessed using dose‐volume and dose‐function metrics. Results: Fifteen percent of the stage I cohort and 33{\%} of the stage III cohort had ventilation defects. The ipsilateral/contralateral ventilation ratio was significantly different (p=0.005) between stage I (ratio=1.06) and stage III (ratio=0.83) patients. Similarly, the SD of stage I and stage III patients was significantly different (p=0.023). Representative functional avoidance plans are presented for both stage I and III groups that improve dose sparing of functional lung. Conclusion: Patients at varying stages of lung disease have different functional profiles and require unique strategies to create functional avoidance plans. We present quantitative data to highlight the impaired lung function of advanced disease patients and explore the potential of using that functional information to adapt plans to a patients ventilation profile. Our study presents an important step of incorporating 4DCT‐based ventilation imaging into the clinic.",
author = "Y. Vinogradskiy and L. Schubert and R. Castillo and E. Castillo and M. Martel and T. Guerrero and M. Miften",
year = "2013",
doi = "10.1118/1.4815339",
language = "English (US)",
volume = "40",
journal = "Medical Physics",
issn = "0094-2405",
publisher = "AAPM - American Association of Physicists in Medicine",
number = "6",

}

TY - JOUR

T1 - TU‐A‐WAB‐05

T2 - Using 4DCT‐Ventilation Based Multi‐Modality Imaging to Assess Lung Function and Optimize Radiation Therapy for Lung Cancer Patients

AU - Vinogradskiy, Y.

AU - Schubert, L.

AU - Castillo, R.

AU - Castillo, E.

AU - Martel, M.

AU - Guerrero, T.

AU - Miften, M.

PY - 2013

Y1 - 2013

N2 - Purpose: A new form of imaging has been developed to assess ventilation‐based lung function using 4DCT. Because 4DCTs are acquired as part of thoracic simulation, calculation of 4DCT‐ventilation maps enables exciting opportunities to assess pre‐treatment lung function and create functional avoidance radiotherapy plans. The purpose of our work was to use 4DCT‐ventilation to evaluate lung function differences between stage I and III lung cancer patients and investigate strategies to adapt plans to a patients ventilation profile. Methods: We retrospectively analyzed 40 stage I and 69 stage III lung cancer patients collected from 2 different institutions. Pre‐treatment ventilation maps were calculated using the simulation 4DCT, deformable image registration, and a density‐change based model. To assess ventilation homogeneity of stage I and III patients we studied visually observed ventilation defects, an ipsilateral/contralateral ventilation ratio, and the standard deviation (SD) of lung ventilation. Plans for both stage groups were created using ventilation‐based functional avoidance maps. The feasibility and quality of plans was assessed using dose‐volume and dose‐function metrics. Results: Fifteen percent of the stage I cohort and 33% of the stage III cohort had ventilation defects. The ipsilateral/contralateral ventilation ratio was significantly different (p=0.005) between stage I (ratio=1.06) and stage III (ratio=0.83) patients. Similarly, the SD of stage I and stage III patients was significantly different (p=0.023). Representative functional avoidance plans are presented for both stage I and III groups that improve dose sparing of functional lung. Conclusion: Patients at varying stages of lung disease have different functional profiles and require unique strategies to create functional avoidance plans. We present quantitative data to highlight the impaired lung function of advanced disease patients and explore the potential of using that functional information to adapt plans to a patients ventilation profile. Our study presents an important step of incorporating 4DCT‐based ventilation imaging into the clinic.

AB - Purpose: A new form of imaging has been developed to assess ventilation‐based lung function using 4DCT. Because 4DCTs are acquired as part of thoracic simulation, calculation of 4DCT‐ventilation maps enables exciting opportunities to assess pre‐treatment lung function and create functional avoidance radiotherapy plans. The purpose of our work was to use 4DCT‐ventilation to evaluate lung function differences between stage I and III lung cancer patients and investigate strategies to adapt plans to a patients ventilation profile. Methods: We retrospectively analyzed 40 stage I and 69 stage III lung cancer patients collected from 2 different institutions. Pre‐treatment ventilation maps were calculated using the simulation 4DCT, deformable image registration, and a density‐change based model. To assess ventilation homogeneity of stage I and III patients we studied visually observed ventilation defects, an ipsilateral/contralateral ventilation ratio, and the standard deviation (SD) of lung ventilation. Plans for both stage groups were created using ventilation‐based functional avoidance maps. The feasibility and quality of plans was assessed using dose‐volume and dose‐function metrics. Results: Fifteen percent of the stage I cohort and 33% of the stage III cohort had ventilation defects. The ipsilateral/contralateral ventilation ratio was significantly different (p=0.005) between stage I (ratio=1.06) and stage III (ratio=0.83) patients. Similarly, the SD of stage I and stage III patients was significantly different (p=0.023). Representative functional avoidance plans are presented for both stage I and III groups that improve dose sparing of functional lung. Conclusion: Patients at varying stages of lung disease have different functional profiles and require unique strategies to create functional avoidance plans. We present quantitative data to highlight the impaired lung function of advanced disease patients and explore the potential of using that functional information to adapt plans to a patients ventilation profile. Our study presents an important step of incorporating 4DCT‐based ventilation imaging into the clinic.

UR - http://www.scopus.com/inward/record.url?scp=85024805394&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85024805394&partnerID=8YFLogxK

U2 - 10.1118/1.4815339

DO - 10.1118/1.4815339

M3 - Article

VL - 40

JO - Medical Physics

JF - Medical Physics

SN - 0094-2405

IS - 6

ER -