Catarina Veiga1, David Landau2, Jamie R McClelland3, Jonathan A Ledermann4, David Hawkes3, Sam M Janes5, Anand Devaraj6. 1. Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering, University College London, London, UK. Electronic address: c.veiga@ucl.ac.uk. 2. Department of Oncology, Guy's & St. Thomas' NHS Trust, London, UK; Department of Oncology, University College London Hospital, London, UK. 3. Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering, University College London, London, UK. 4. Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK. 5. Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK. 6. Department of Radiology, Royal Brompton Hospital, London, UK.
Abstract
PURPOSE: To describe the radiological findings of radiation-induced lung damage (RILD) present on CT imaging of lung cancer patients 12 months after radical chemoradiation. MATERIAL AND METHODS: Baseline and 12-month CT scans of 33 patients were reviewed from a phase I/II clinical trial of isotoxic chemoradiation (IDEAL CRT). CT findings were scored in three categories derived from eleven sub-categories: (1) parenchymal change, defined as the presence of consolidation, ground-glass opacities (GGOs), traction bronchiectasis and/or reticulation; (2) lung volume reduction, identified through reduction in lung height and/or distortions in fissures, diaphragm, anterior junction line and major airways anatomy, and (3) pleural changes, either thickening and/or effusion. RESULTS: Six patients were excluded from the analysis due to anatomical changes caused by partial lung collapse and abscess. All remaining 27 patients had radiological evidence of lung damage. The three categories, parenchymal change, shrinkage and pleural change were present in 100%, 96% and 82% respectively. All patients had at least two categories of change present and 72% all three. GGOs, reticulation and traction bronchiectasis were present in 44%, 52% and 37% of patients. CONCLUSIONS: Parenchymal change, lung shrinkage and pleural change are present in a high proportion of patients and are frequently identified in RILD. GGOs, reticulation and traction bronchiectasis are common at 12 months but not diagnostic.
PURPOSE: To describe the radiological findings of radiation-induced lung damage (RILD) present on CT imaging of lung cancerpatients 12 months after radical chemoradiation. MATERIAL AND METHODS: Baseline and 12-month CT scans of 33 patients were reviewed from a phase I/II clinical trial of isotoxic chemoradiation (IDEAL CRT). CT findings were scored in three categories derived from eleven sub-categories: (1) parenchymal change, defined as the presence of consolidation, ground-glass opacities (GGOs), traction bronchiectasis and/or reticulation; (2) lung volume reduction, identified through reduction in lung height and/or distortions in fissures, diaphragm, anterior junction line and major airways anatomy, and (3) pleural changes, either thickening and/or effusion. RESULTS: Six patients were excluded from the analysis due to anatomical changes caused by partial lung collapse and abscess. All remaining 27 patients had radiological evidence of lung damage. The three categories, parenchymal change, shrinkage and pleural change were present in 100%, 96% and 82% respectively. All patients had at least two categories of change present and 72% all three. GGOs, reticulation and traction bronchiectasis were present in 44%, 52% and 37% of patients. CONCLUSIONS: Parenchymal change, lung shrinkage and pleural change are present in a high proportion of patients and are frequently identified in RILD. GGOs, reticulation and traction bronchiectasis are common at 12 months but not diagnostic.
Authors: Catarina Veiga; Edward Chandy; Joseph Jacob; Natalie Yip; Adam Szmul; David Landau; Jamie R McClelland Journal: Radiother Oncol Date: 2020-03-30 Impact factor: 6.280
Authors: Adam Szmul; Edward Chandy; Catarina Veiga; Joseph Jacob; Alkisti Stavropoulou; David Landau; Crispin T Hiley; Jamie R McClelland Journal: Cancers (Basel) Date: 2022-03-05 Impact factor: 6.639
Authors: Khinh Ranh Voong; Sarah Z Hazell; Wei Fu; Chen Hu; Cheng Ting Lin; Kai Ding; Karthik Suresh; Jonathan Hayman; Russell K Hales; Salem Alfaifi; Kristen A Marrone; Benjamin Levy; Christine L Hann; David S Ettinger; Josephine L Feliciano; Valerie Peterson; Ronan J Kelly; Julie R Brahmer; Patrick M Forde; Jarushka Naidoo Journal: Clin Lung Cancer Date: 2019-03-28 Impact factor: 4.785
Authors: John D Fenwick; David B Landau; Angela T Baker; Andrew T Bates; Chinnamani Eswar; Angel Garcia-Alonso; Susan V Harden; Marianne C Illsley; Virginia Laurence; Zafar Malik; William Philip M Mayles; Elizabeth Miles; Nazia Mohammed; James Spicer; Paula Wells; Sindu Vivekanandan; Anne-Marie Mullin; Laura Hughes; Laura Farrelly; Yenting Ngai; Nicholas Counsell Journal: Int J Radiat Oncol Biol Phys Date: 2019-12-03 Impact factor: 7.038