방사선종양학

  • [Sci Rep.] Single photon emission computed tomography (SPECT) or positron emission tomography (PET) imaging for radiotherapy planning in patients with lung cancer: a meta-analysis

    한양의대 / 이수진, 박혜진*

  • 출처
    Sci Rep.
  • 등재일
    2020 Sep 10
  • 저널이슈번호
    10(1):14864. doi: 10.1038/s41598-020-71445-5.
  • 내용

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    Abstract
    Functional imaging modalities enable practitioners to identify functional lung regions. This analysis evaluated the feasibility of nuclear medicine imaging to avoid doses to the functional lung in radiotherapy (RT) planning for patients with lung cancer. This systematic review and meta-analysis was carried out according to PRISMA-P guidelines. A search of EMBASE and PubMed for studies published throughout the last 20 years was performed using the following search criteria: (a) 'lung cancer' or 'lung malignancy' and (b) 'radiotherapy' or 'radiation therapy' or 'RT planning' and (c) 'SPECT' or 'single positron emission computed tomography' or 'functional image.' The analyzed planning parameters were the volumes of the normal lung that have received ≥ 10 Gy and ≥ 20 Gy of radiation (V10 and V20, respectively) and the mean lung dose (MLD). We compared the planning parameters obtained from anatomical RT planning and functional RT planning using perfusion or ventilation imaging ('V10, V20 or MLD' in anatomical plan vs. 'fV10, fV20 or fMLD' in functional plan). A total of 309 patients with 344 RT plan sets from 15 publications (11 perfusion SPECT, 2 ventilation SPECT, and 1 SPECT and 1 PET with both perfusion and ventilation) were included in the meta-analysis. The standard mean differences in planning parameters in functional plans using nuclear imaging were significantly reduced compared to those of anatomical plans (P < 0.01 for all): - 0.42 (95% confidence interval (CI) - 0.78 to - 0.07) for 'V10 vs. fV10', - 0.41 (95% CI - 0.64 to - 0.17) for 'V20 vs. fV20', and - 0.24 (95% CI - 0.45 to - 0.03) for 'MLD vs. fMLD'. In subgroup analysis, the functional plan using perfusion was significantly lower than the anatomical plan in all planning parameters, but there was no significant difference for ventilation. RT planning with nuclear functional lung imaging has potential to reduce radiation-induced lung injury. Perfusion imaging seems to be more promising than ventilation imaging for all planning parameters. There were not enough studies using ventilation imaging to determine what the effect is on the lung plan parameters.

     

    Affiliations

    Soo Jin Lee  1 , Hae Jin Park  2
    1 Department of Nuclear Medicine, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea.
    2 Department of Radiation Oncology, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea. haejin.park.md@gmail.com.

  • 편집위원

    폐암에서 SPECT 혹은 PET을 이용한 기능적 방사선치료계획과 기존의 해부학적 방사선치료계획을 비교한 연구들을 메타분석한 논문. 관류 영상을 이용한 기능적 방사선치료계획이 평균폐선량 등을 낮출 수 있음을 보여줌.

    2020-11-10 09:33:50

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