Sachiko Miura MD, Presenter: Nothing to Disclose

Yoshiharu Ohno MD, PhD, Abstract Co-Author: Research Grant, Toshiba Corporation Research Grant, Koninklijke Philips NV Research Grant, Bayer AG Research Grant, DAIICHI SANKYO Group Research Grant, Eisai Co, Ltd Research Grant, Terumo Corporation Research Grant, Fuji Yakuhin Co, Ltd Research Grant, FUJIFILM Holdings Corporation Research Grant, Guerbet SA

Hiroshi Okada, Abstract Co-Author: Nothing to Disclose

Hiroshi Kimura, Abstract Co-Author: Nothing to Disclose

Masatoshi Hasegawa, Abstract Co-Author: Nothing to Disclose

Kimihiko Kichikawa MD, Abstract Co-Author: Nothing to Disclose

To evaluate the utility of lung perfused blood volume (PBV) map from dual-energy CT (DECT) for pulmonary functional loss assessment and radiation pneumonitis prediction in non-small cell lung cancer (NSCLC) patients.

30 NSCLC patients who received conventional radical radiation therapy (RT) underwent DECT examinations at 4 time points (i.e. before, during, 1 week after, and 1 month after RTs) and follow-up examination including pulmonary function test. From each DECT data, a normalized lung PBV (nPBV) map was generated by commercially available software in each patient. To evaluate lung perfusion abnormality due to RT, nPBV values were determined as averages of all ROI measurements within the planning target volume (PTV), lung volumes that received 20Gy, 40Gy and 60Gy, and lung outside of the RT field at each time point. According to follow-up examination results, all patients were divided into radiation pneumonitis (n=23) and non-pneumonitis (n=7) groups. To assess the difference of nPBV value between the two groups at each time-point, nPBV value within each location was compared between the two groups by Student’s t-test. To determine the capability of nPBV values for pulmonary functional loss assessment, nPBV values within each location at all time points as having significant difference between the two groups were correlated with %VC and %FEV1. To evaluate the capability of nPBV value for radiation pneumonitis prediction, the feasible threshold value of nPBV during RT was determined by ROC-based positive test, and its differentiation capability was also assessed.      

At all time points except before RT, nPBV values within PTV had significant differences between the two groups (p<0.05). nPBV values within PTV had significant and good correlation with %VC at the same time points (during RT: r=0.66, p=0.03; 1 week after RT: r=0.70, p=0.02; 1 month after: r=0.61, p<0.05). When applied the feasible threshold value, sensitivity, specificity and accuracy for early prediction of radiation pneumonitis were as follows: 100 (22/22) %, 37.5 (3/8) % and 83.3 (25/30) %. 

Lung PBV map from DECT is useful for pulmonary functional loss assessment and radiation pneumonitis prediction in NSCLC patients.

Lung PBV map from DECT is useful for pulmonary functional loss assessment and radiation pneumonitis prediction in NSCLC patients. 

Miura, S, Ohno, Y, Okada, H, Kimura, H, Hasegawa, M, Kichikawa, K, Quantitative Assessment of Lung Perfusion on Dual-Energy CT: Utility for Pulmonary Functional Loss Assessment and Radiation Pneumonitis Prediction in Non-Small Cell Lung Cancer Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013268.html