Richard Castillo1, Ngoc Pham, Edward Castillo, Samantha Aso-Gonzalez, Sobiya Ansari, Brian Hobbs, Diana Palacio, Heath Skinner, Thomas M Guerrero. 1. From the Department of Radiation Oncology, The University of Texas Medical Branch, Galveston, Tex (R.C.); Department of Radiation Oncology, Baylor College of Medicine, Houston, Tex (N.P.); Department of Radiation Oncology, Beaumont Health System, 3601 W Thirteen Mile Rd, Royal Oak, MI 48073-6769 (E.C., T.M.G.); Department of Computational and Applied Mathematics, Rice University, Houston, Tex (E.C., T.M.G.); Department of Pulmonology, Bellvitge Hospital, University of Barcelona, Barcelona, Spain (S.A.G.); Department of Radiation Oncology, University of Chicago, Chicago, Ill (S.A.); and Divisions of Quantitative Sciences (B.H.), Diagnostic Imaging (D.P.), and Radiation Oncology (H.S.), The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
PURPOSE: To examine the association between pre-radiation therapy (RT) fluorine 18 fluorodeoxyglucose (FDG) uptake and post-RT symptomatic radiation pneumonitis (RP). MATERIALS AND METHODS: In accordance with the retrospective study protocol approved by the institutional review board, 228 esophageal cancer patients who underwent FDG PET/CT before chemotherapy and RT were examined. RP symptoms were evaluated by using the Common Terminology Criteria for Adverse Events, version 4.0, from the consensus of five clinicians. By using the cumulative distribution of standardized uptake values (SUVs) within the lungs, those values greater than 80%-95% of the total lung voxels were determined for each patient. The effect of pre-chemotherapy and RT FDG uptake, dose, and patient or treatment characteristics on RP toxicity was studied by using logistic regression. RESULTS: The study subjects were treated with three-dimensional conformal RT (n = 36), intensity-modulated RT (n = 135), or proton therapy (n = 57). Logistic regression analysis demonstrated elevated FDG uptake at pre-chemotherapy and RT was related to expression of RP symptoms. Study subjects with elevated 95% percentile of the SUV (SUV95) were more likely to develop symptomatic RP (P < .000012); each 0.1 unit increase in SUV95 was associated with a 1.36-fold increase in the odds of symptomatic RP. Receiver operating characteristic (ROC) curve analysis resulted in area under the ROC curve of 0.676 (95% confidence interval: 0.58, 0.77), sensitivity of 60%, and specificity of 71% at the 1.17 SUV95 threshold. CT imaging and dosimetric parameters were found to be poor predictors of RP symptoms. CONCLUSION: The SUV95, a biomarker of pretreatment pulmonary metabolic activity, was shown to be prognostic of symptomatic RP. Elevation in this pretreatment biomarker identifies patients at high risk for posttreatment symptomatic RP. RSNA, 2015
PURPOSE: To examine the association between pre-radiation therapy (RT) fluorine 18 fluorodeoxyglucose (FDG) uptake and post-RT symptomatic radiation pneumonitis (RP). MATERIALS AND METHODS: In accordance with the retrospective study protocol approved by the institutional review board, 228 esophageal cancerpatients who underwent FDG PET/CT before chemotherapy and RT were examined. RP symptoms were evaluated by using the Common Terminology Criteria for Adverse Events, version 4.0, from the consensus of five clinicians. By using the cumulative distribution of standardized uptake values (SUVs) within the lungs, those values greater than 80%-95% of the total lung voxels were determined for each patient. The effect of pre-chemotherapy and RT FDG uptake, dose, and patient or treatment characteristics on RP toxicity was studied by using logistic regression. RESULTS: The study subjects were treated with three-dimensional conformal RT (n = 36), intensity-modulated RT (n = 135), or proton therapy (n = 57). Logistic regression analysis demonstrated elevated FDG uptake at pre-chemotherapy and RT was related to expression of RP symptoms. Study subjects with elevated 95% percentile of the SUV (SUV95) were more likely to develop symptomatic RP (P < .000012); each 0.1 unit increase in SUV95 was associated with a 1.36-fold increase in the odds of symptomatic RP. Receiver operating characteristic (ROC) curve analysis resulted in area under the ROC curve of 0.676 (95% confidence interval: 0.58, 0.77), sensitivity of 60%, and specificity of 71% at the 1.17 SUV95 threshold. CT imaging and dosimetric parameters were found to be poor predictors of RP symptoms. CONCLUSION: The SUV95, a biomarker of pretreatment pulmonary metabolic activity, was shown to be prognostic of symptomatic RP. Elevation in this pretreatment biomarker identifies patients at high risk for posttreatment symptomatic RP. RSNA, 2015
Authors: Zafer Kocak; Gerben R Borst; Jing Zeng; Sumin Zhou; Donna R Hollis; Junan Zhang; Elizabeth S Evans; Rodney J Folz; Terrence Wong; Daniel Kahn; Jose S A Belderbos; Joos V Lebesque; Lawrence B Marks Journal: Int J Radiat Oncol Biol Phys Date: 2007-01-01 Impact factor: 7.038
Authors: Steven F Petit; Wouter J C van Elmpt; Cary J G Oberije; Erik Vegt; Anne-Marie C Dingemans; Philippe Lambin; André L A J Dekker; Dirk De Ruysscher Journal: Int J Radiat Oncol Biol Phys Date: 2010-09-29 Impact factor: 7.038
Authors: Delphine L Chen; Thomas W Ferkol; Mark A Mintun; Jessica E Pittman; Daniel B Rosenbluth; Daniel P Schuster Journal: Am J Respir Crit Care Med Date: 2006-03-16 Impact factor: 21.405
Authors: Yevgeniy Vinogradskiy; Quentin Diot; Bernard Jones; Richard Castillo; Edward Castillo; Jennifer Kwak; Daniel Bowles; Inga Grills; Nicholas Myziuk; Thomas Guerrero; Craig Stevens; Tracey Schefter; Laurie E Gaspar; Brian Kavanagh; Moyed Miften; Chad Rusthoven Journal: Int J Radiat Oncol Biol Phys Date: 2020-01-23 Impact factor: 7.038
Authors: Gregory J Anthony; Alexandra Cunliffe; Richard Castillo; Ngoc Pham; Thomas Guerrero; Samuel G Armato; Hania A Al-Hallaq Journal: Med Phys Date: 2017-05-22 Impact factor: 4.071
Authors: J J Tonison; S G Fischer; M Viehrig; S Welz; S Boeke; K Zwirner; B Klumpp; L H Braun; D Zips; C Gani Journal: Sci Rep Date: 2019-02-19 Impact factor: 4.379
Authors: Samantha Aso; Arturo Navarro-Martin; Richard Castillo; Susana Padrones; Edward Castillo; Ana Montes; José Ignacio Martínez; Noelia Cubero; Rosa López; Laura Rodríguez; Ramon Palmero; Federico Manresa; Thomas Guerrero; María Molina Journal: Radiat Oncol Date: 2020-10-27 Impact factor: 3.481