Radiation-Induced Reductions in Regional Lung Perfusion: 0.1-12 Year Data From a Prospective Clinical Study

Junan Zhang, Jinli Ma, Sumin Zhou, Jessica L. Hubbs, Terence Z. Wong, Rodney J. Folz, Elizabeth S. Evans, Ronald J. Jaszczak, Robert Clough, Lawrence B. Marks

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52 Scopus citations

Abstract

Purpose: To assess the time and regional dependence of radiation therapy (RT)-induced reductions in regional lung perfusion 0.1-12 years post-RT, as measured by single photon emission computed tomography (SPECT) lung perfusion. Materials/Methods: Between 1991 and 2005, 123 evaluable patients receiving RT for tumors in/around the thorax underwent SPECT lung perfusion scans before and serially post-RT (0.1-12 years). Registration of pre- and post-RT SPECT images with the treatment planning computed tomography, and hence the three-dimensional RT dose distribution, allowed changes in regional SPECT-defined perfusion to be related to regional RT dose. Post-RT follow-up scans were evaluated at multiple time points to determine the time course of RT-induced regional perfusion changes. Population dose response curves (DRC) for all patients at different time points, different regions, and subvolumes (e.g., whole lungs, cranial/caudal, ipsilateral/contralateral) were generated by combining data from multiple patients at similar follow-up times. Each DRC was fit to a linear model, and differences statistically analyzed. Results: In the overall groups, dose-dependent reductions in perfusion were seen at each time post-RT. The slope of the DRC increased over time up to 18 months post-RT, and plateaued thereafter. Regional differences in DRCs were only observed between the ipsilateral and contralateral lungs, and appeared due to tumor-associated changes in regional perfusion. Conclusions: Thoracic RT causes dose-dependent reductions in regional lung perfusion that progress up to ∼18 months post-RT and persists thereafter. Tumor shrinkage appears to confound the observed dose-response relations. There appears to be similar dose response for healthy parts of the lungs at different locations.

Original languageEnglish (US)
Pages (from-to)425-432
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume76
Issue number2
DOIs
StatePublished - Feb 1 2010

Keywords

  • Lung
  • Radiation injury
  • SPECT

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Zhang, J., Ma, J., Zhou, S., Hubbs, J. L., Wong, T. Z., Folz, R. J., Evans, E. S., Jaszczak, R. J., Clough, R., & Marks, L. B. (2010). Radiation-Induced Reductions in Regional Lung Perfusion: 0.1-12 Year Data From a Prospective Clinical Study. International Journal of Radiation Oncology Biology Physics, 76(2), 425-432. https://doi.org/10.1016/j.ijrobp.2009.02.005