BACKGROUND: Lung cancer is the No. 1 cancer killer of both men and women in the United States. Radiotherapy is frequently employed as part of the treatment. However, radiation must traverse surrounding regions of normal lung, potentially inducing pulmonary toxicity. Because these patients frequently have underlying lung disease, a radiation-induced decrement in lung function could be highly morbid or even fatal. It is well known that lung function is not uniform, with wide ranges of ventilation and perfusion levels throughout the lung. Currently radiation oncologists do not have the ability to account for this variation when generating treatment plans. METHODS: This article reviews some techniques used to assess pulmonary ventilation and perfusion, including nuclear medicine, magnetic resonance imaging (MRI) and computed tomography (CT). RESULTS: Many techniques have the potential to be used in radiotherapy treatment planning for thoracic cancer patients to spare normal functional lung volumes while delivering adequate radiation dose to the tumors. The article outlines a promising new technique to generate 3-D ventilation maps by using deformable image registration of 4-D CT image sets. CONCLUSIONS: While there are some technical challenges to overcome before pulmonary functional imaging can be routinely employed clinically in radiation oncology, there is the potential to preferentially spare better perfused/ventilated regions of normal lung, which promises to reduce pulmonary toxicity.
BACKGROUND: Lung cancer is the No. 1 cancer killer of both men and women in the United States. Radiotherapy is frequently employed as part of the treatment. However, radiation must traverse surrounding regions of normal lung, potentially inducing pulmonary toxicity. Because these patients frequently have underlying lung disease, a radiation-induced decrement in lung function could be highly morbid or even fatal. It is well known that lung function is not uniform, with wide ranges of ventilation and perfusion levels throughout the lung. Currently radiation oncologists do not have the ability to account for this variation when generating treatment plans. METHODS: This article reviews some techniques used to assess pulmonary ventilation and perfusion, including nuclear medicine, magnetic resonance imaging (MRI) and computed tomography (CT). RESULTS: Many techniques have the potential to be used in radiotherapy treatment planning for thoracic cancerpatients to spare normal functional lung volumes while delivering adequate radiation dose to the tumors. The article outlines a promising new technique to generate 3-D ventilation maps by using deformable image registration of 4-D CT image sets. CONCLUSIONS: While there are some technical challenges to overcome before pulmonary functional imaging can be routinely employed clinically in radiation oncology, there is the potential to preferentially spare better perfused/ventilated regions of normal lung, which promises to reduce pulmonary toxicity.
Authors: Robert Jeraj; Yue Cao; Randall K Ten Haken; Carol Hahn; Lawrence Marks Journal: Int J Radiat Oncol Biol Phys Date: 2010-03-01 Impact factor: 7.038
Authors: Shuanghu Tiger Yuan; Kirk A Frey; Milton D Gross; James A Hayman; Doug Arenberg; Jeffrey L Curtis; Xu-Wei Cai; Nithya Ramnath; Gregory P Kalemkerian; Randall K Ten Haken; Avraham Eisbruch; Feng-Ming Spring Kong Journal: J Thorac Oncol Date: 2011-01 Impact factor: 15.609
Authors: Kujtim Latifi; Kenneth M Forster; Sarah E Hoffe; Thomas J Dilling; Wouter van Elmpt; Andre Dekker; Geoffrey G Zhang Journal: J Appl Clin Med Phys Date: 2013-07-08 Impact factor: 2.102