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MRI-based ventilation and perfusion imaging to predict radiation-induced pneumonitis in lung tumor patients at a 0.35T MR-Linac.
Klaar, Rabea; Rabe, Moritz; Stüber, Anna Theresa; Hering, Svenja; Corradini, Stefanie; Eze, Chukwuka; Marschner, Sebastian; Belka, Claus; Landry, Guillaume; Dinkel, Julien; Kurz, Christopher.
Afiliación
  • Klaar R; Department of Radiology, LMU University Hospital, LMU Munich, Munich, 81377, Germany; Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, 81377, Germany. Electronic address: rabea.klaar@med.uni-muenchen.de.
  • Rabe M; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, 81377, Germany.
  • Stüber AT; Department of Radiology, LMU University Hospital, LMU Munich, Munich, 81377, Germany; Department of Statistics, LMU Munich, Munich, 80539, Germany; Munich Center for Machine Learning (MCML), Munich, 80539, Germany.
  • Hering S; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, 81377, Germany.
  • Corradini S; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, 81377, Germany.
  • Eze C; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, 81377, Germany.
  • Marschner S; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, 81377, Germany.
  • Belka C; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, 81377, Germany; German Cancer Consortium (DKTK), partner site Munich, a partnership between DKFZ and LMU University Hospital Munich, Munich, 80336, Germany; Bavarian Cancer Research Center (BZKF), Munich, 80336, Germany.
  • Landry G; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, 81377, Germany.
  • Dinkel J; Department of Radiology, LMU University Hospital, LMU Munich, Munich, 81377, Germany; Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, 81377, Germany.
  • Kurz C; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, 81377, Germany.
Radiother Oncol ; 199: 110468, 2024 10.
Article en En | MEDLINE | ID: mdl-39111637
ABSTRACT
BACKGROUND AND

PURPOSE:

Radiation-induced pneumonitis (RP), diagnosed 6-12 weeks after treatment, is a complication of lung tumor radiotherapy. So far, clinical and dosimetric parameters have not been reliable in predicting RP. We propose using non-contrast enhanced magnetic resonance imaging (MRI) based functional parameters acquired over the treatment course for patient stratification for improved follow-up. MATERIALS AND

METHODS:

23 lung tumor patients received MR-guided hypofractionated stereotactic body radiation therapy at a 0.35T MR-Linac. Ventilation- and perfusion-maps were generated from 2D-cine MRI-scans acquired after the first and last treatment fraction (Fx) using non-uniform Fourier decomposition. The relative differences in ventilation and perfusion between last and first Fx in three regions (planning target volume (PTV), lung volume receiving more than 20Gy (V20) excluding PTV, whole tumor-bearing lung excluding PTV) and three dosimetric parameters (mean lung dose, V20, mean dose to the gross tumor volume) were investigated. Univariate receiver operating characteristic curve - area under the curve (ROC-AUC) analysis was performed (endpoint RP grade≥1) using 5000 bootstrapping samples. Differences between RP and non-RP patients were tested for statistical significance with the non-parametric Mann-Whitney U test (α=0.05).

RESULTS:

14/23 patients developed RP of grade≥1 within 3 months. The dosimetric parameters showed no significant differences between RP and non-RP patients. In contrast, the functional parameters, especially the relative ventilation difference in the PTV, achieved a p-value<0.05 and an AUC value of 0.84.

CONCLUSION:

MRI-based functional parameters extracted from 2D-cine MRI-scans were found to be predictive of RP development in lung tumor patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Magnética / Neumonitis por Radiación / Neoplasias Pulmonares Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Radiother Oncol Año: 2024 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Magnética / Neumonitis por Radiación / Neoplasias Pulmonares Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Radiother Oncol Año: 2024 Tipo del documento: Article Pais de publicación: Irlanda