The incorporation of SPECT functional lung imaging into inverse radiotherapy planning for non-small cell lung cancer

TY - JOUR

T1 - The incorporation of SPECT functional lung imaging into inverse radiotherapy planning for non-small cell lung cancer

AU - Christian, J. A.

AU - Partridge, M.

AU - Nioutsikou, E.

AU - Cook, G.

AU - McNair, H. A.

AU - Cronin, B.

AU - Courbon, F.

AU - Bedford, J. L.

AU - Brada, M.

PY - 2005/12

Y1 - 2005/12

N2 - Background and purpose: Patients with non-small cell lung cancer (NSCLC) often have inhomogeneous lung perfusion. Radiotherapy planning computed tomography (CT) scans have been accurately co-registered with lung perfusion single photon emission computed tomography (SPECT) scans to design radiotherapy treatments which limit dose to healthy 'perfused' lung. Patients and methods: Patients with localised NSCLC had CT and SPECT scans accurately co-registered in the planning system. The SPECT images were used to define a volume of perfused 'functioning' lung (FL). Inverse planning software was used to create 3D-conformal plans, the planning objective being either to minimise the dose to whole lungs (WL) or to minimise the dose to FL. Results: Four plans were created for each of six patients. The mean difference in volume between WL and FL was 1011.7 cm(3) (range 596.2-1581.1 cm(3)). One patient with bilateral upper lobe perfusion deficits had a 16% reduction in FLV20 (the percentage volume of functioning lung receiving >= 20 Gy). The remaining patients had inhomogeneous perfusion deficits such that inverse planning was not able to sufficiently optimise beam angles to avoid functioning lung. Conclusion: SPECT perfusion images can be accurately co-registered with radiotherapy planning CT scans and may be helpful in creating treatment plans for patients with large perfusion deficits.

AB - Background and purpose: Patients with non-small cell lung cancer (NSCLC) often have inhomogeneous lung perfusion. Radiotherapy planning computed tomography (CT) scans have been accurately co-registered with lung perfusion single photon emission computed tomography (SPECT) scans to design radiotherapy treatments which limit dose to healthy 'perfused' lung. Patients and methods: Patients with localised NSCLC had CT and SPECT scans accurately co-registered in the planning system. The SPECT images were used to define a volume of perfused 'functioning' lung (FL). Inverse planning software was used to create 3D-conformal plans, the planning objective being either to minimise the dose to whole lungs (WL) or to minimise the dose to FL. Results: Four plans were created for each of six patients. The mean difference in volume between WL and FL was 1011.7 cm(3) (range 596.2-1581.1 cm(3)). One patient with bilateral upper lobe perfusion deficits had a 16% reduction in FLV20 (the percentage volume of functioning lung receiving >= 20 Gy). The remaining patients had inhomogeneous perfusion deficits such that inverse planning was not able to sufficiently optimise beam angles to avoid functioning lung. Conclusion: SPECT perfusion images can be accurately co-registered with radiotherapy planning CT scans and may be helpful in creating treatment plans for patients with large perfusion deficits.

U2 - 10.1016/j.radonc.2005.08.008

DO - 10.1016/j.radonc.2005.08.008

M3 - Article

SN - 0167-8140

VL - 77

SP - 271

EP - 277

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

IS - 3

ER -