Lucia François, Bourhis David, Blanc-Béguin Frédérique, Goasduff Gaëlle, Hamya Mohamed, Hennebicq Simon, Mauguen Maëlle, Floch Romain, Geier Margaux, Schick Ulrike, Consigny Maëlys, Pradier Olivier, Gal Grégoire Le, Salaun Pierre-Yves, Bourbonne Vincent, Roux Pierre-Yves Le
Radiation Oncology Department, University Hospital, Brest, France.
LaTIM, INSERM, UMR 1101, University of Brest 29200 Brest, France.
Phys Imaging Radiat Oncol. 2025 May 17;34:100786. doi: 10.1016/j.phro.2025.100786. eCollection 2025 Apr.
To compare the performance of anatomic and functional dosimetric parameters based on Gallium-68 lung perfusion positron emission tomography and computed tomographic imaging (PET/CT) imaging to predict the risk of symptomatic long-term radiation-induced lung toxicity (RILT) in patients with lung tumors treated with stereotactic body radiation therapy (SBRT).
We have performed a prospective study in patients treated with SBRT. Mean dose (MD) and volumes receiving xGy were calculated in five lung volumes: the conventional anatomical volume (AV) delineated on CT images, three lung functional volumes defined on lung perfusion PET imaging (FV50%, FV70%, FV90%, i.e. the minimal volume containing 50 %, 70 % and 90 % of the total activity within the AV), and a low functional volume (LFV = AV-FV90%). The primary endpoint of this analysis was grade ≥2 long-term RILT at 12 months as assessed with NCI CTCAE v.5. The predictive value of anatomical and functional dose volume parameters was evaluated by comparing patients with and without long-term RILT.
Out of the 59 patients included, 50 were still alive at 12 months and 9 (18 %) had grade ≥2 long-term RILT. The MD and the VxGy in the AV and LFV were not statistically different in patients with and without long-term RILT (p > 0.05). All functional parameters in FV50% and FV70% were significantly higher in long-term RILT patients (p < 0.05).
The predictive value of PET perfusion-based functional parameters outperforms the standard CT-based dose-volume parameters for the risk of grade ≥2 long-term RILT.
比较基于镓 - 68肺灌注正电子发射断层扫描和计算机断层扫描成像（PET/CT）的解剖学和功能剂量学参数，以预测接受立体定向体部放射治疗（SBRT）的肺部肿瘤患者发生有症状的长期放射性肺损伤（RILT）的风险。
我们对接受SBRT治疗的患者进行了一项前瞻性研究。在五个肺容积中计算平均剂量（MD）和接受xGy的体积：在CT图像上勾勒出的传统解剖学容积（AV）、在肺灌注PET成像上定义的三个肺功能容积（FV50%、FV70%、FV90%，即包含AV内总活性50%、70%和90%的最小容积）以及一个低功能容积（LFV = AV - FV90%）。该分析的主要终点是根据美国国立癌症研究所（NCI）CTCAE v.5评估的12个月时≥2级的长期RILT。通过比较有和没有长期RILT的患者来评估解剖学和功能剂量体积参数的预测价值。
在纳入的59例患者中，50例在12个月时仍存活，9例（18%）发生≥2级长期RILT。有和没有长期RILT的患者在AV和LFV中的MD和VxGy无统计学差异（p > 0.05）。长期RILT患者中FV50%和FV70%的所有功能参数均显著更高（p < 0.05）。
对于≥2级长期RILT的风险，基于PET灌注的功能参数的预测价值优于基于标准CT的剂量体积参数。
