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Quantitative evaluation of correlation of dose and FDG-PET uptake value with clinical chest wall complications in patients with lung cancer treated with stereotactic body radiation therapy

Quantitative evaluation of correlation of dose and FDG-PET uptake value with clinical chest wall... The aim of this study was to investigate quantitatively the dosimetricfactors that increase the risk of clinical complications of rib fractures orchest wall pain after stereotactic body radiation therapy (SBRT) to thelung. The correlations of clinical complications with standard-uptake values(SUV) and FDG-PET activity distributions from post-treatment PET-imagingwere studied. Mean and maximum doses from treatment plans, FDG-PET activityvalues on post-SBRT PET scans and the presence of clinical complicationswere determined in fifteen patients undergoing 16 SBRT treatments for lungcancer. SBRT treatments were delivered in 3 to 5 fractions using 5 to 7fields to prescription doses in the range from 39.0 to 60.0 Gy. The dose andFDG-PET activity values were extracted from regions of interest in the chestwall that matched anatomically. Quantitative evaluation of the correlationbetween dose deposition and FDG-PET activity was performed by calculatingthe Pearson correlation coefficient using pixel-by-pixel analysis of doseand FDG-PET activity maps in selected regions of interest associated withclinical complications. Overall, three of fifteen patients developed ribfractures with chest wall pain, and two patients developed pain symptomswithout fracture. The mean dose to the rib cage in patients with fractureswas 37.53 Gy compared to 33.35 Gy in patients without fractures. Increasedchest wall activity as determined by FDG-uptake was noted in patients whodeveloped rib fractures. Enhanced activity from PET-images correlatedstrongly with high doses deposited to the chest wall which could bepredicted by a linear relationship. The local enhanced activity wasassociated with the development of clinical complications such as chest wallinflammation and rib fracture. This study demonstrates that rib fracturesand chest wall pain can occur after SBRT treatments to the lung and isassociated with increased activity on subsequent PET scans. The FDG-PETactivity provides a useful parameter that can be used clinically to predictchest wall complication in lung patients. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of X-Ray Science and Technology IOS Press

Quantitative evaluation of correlation of dose and FDG-PET uptake value with clinical chest wall complications in patients with lung cancer treated with stereotactic body radiation therapy

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Publisher
IOS Press
Copyright
Copyright © 2015 IOS Press and the authors. All rights reserved
ISSN
0895-3996
eISSN
1095-9114
DOI
10.3233/XST-150523
pmid
26756408
Publisher site
See Article on Publisher Site

Abstract

The aim of this study was to investigate quantitatively the dosimetricfactors that increase the risk of clinical complications of rib fractures orchest wall pain after stereotactic body radiation therapy (SBRT) to thelung. The correlations of clinical complications with standard-uptake values(SUV) and FDG-PET activity distributions from post-treatment PET-imagingwere studied. Mean and maximum doses from treatment plans, FDG-PET activityvalues on post-SBRT PET scans and the presence of clinical complicationswere determined in fifteen patients undergoing 16 SBRT treatments for lungcancer. SBRT treatments were delivered in 3 to 5 fractions using 5 to 7fields to prescription doses in the range from 39.0 to 60.0 Gy. The dose andFDG-PET activity values were extracted from regions of interest in the chestwall that matched anatomically. Quantitative evaluation of the correlationbetween dose deposition and FDG-PET activity was performed by calculatingthe Pearson correlation coefficient using pixel-by-pixel analysis of doseand FDG-PET activity maps in selected regions of interest associated withclinical complications. Overall, three of fifteen patients developed ribfractures with chest wall pain, and two patients developed pain symptomswithout fracture. The mean dose to the rib cage in patients with fractureswas 37.53 Gy compared to 33.35 Gy in patients without fractures. Increasedchest wall activity as determined by FDG-uptake was noted in patients whodeveloped rib fractures. Enhanced activity from PET-images correlatedstrongly with high doses deposited to the chest wall which could bepredicted by a linear relationship. The local enhanced activity wasassociated with the development of clinical complications such as chest wallinflammation and rib fracture. This study demonstrates that rib fracturesand chest wall pain can occur after SBRT treatments to the lung and isassociated with increased activity on subsequent PET scans. The FDG-PETactivity provides a useful parameter that can be used clinically to predictchest wall complication in lung patients.

Journal

Journal of X-Ray Science and Technology – IOS Press

Published: Dec 17, 2015

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