Investigating the Incidence of Pulmonary Abnormalities as Identified by Parametric Response Mapping in Patients With Lung Cancer Before Radiation Treatment.
Investigating the Incidence of Pulmonary Abnormalities as Identified by Parametric Response Mapping in Patients With Lung Cancer Before Radiation Treatment.
复制标题
应用参数反应图研究肺癌患者放射治疗前肺部异常的发生率。
DOI：
10.1016/j.adro.2022.100980
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发表时间：
2022-07
影响因子：
2.3
通讯作者：
Matuszak, M M
中科院分区：
文献类型：
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作者：
Owen, Daniel R;Sun, Yilun;Irrer, Jim C;Schipper, Matthew J;Schonewolf, Caitlin A;Galban, Stefanie;Jolly, Shruti;Haken, Randall K Ten;Galban, C J;Matuszak, M M
高分辨率成对吸气和呼气计算机断层扫描（CT）的参数响应映射（PRM）是一种有前途的分析成像技术，目前用于诊断应用，并提供了在患者特定基础上表征和量化某些肺部病变的能力。作为在放射肿瘤学诊所实施这种技术的首批研究之一，这项工作的目标是评估PRM分析的可行性，以确定肺癌患者放射治疗（RT）前的肺部异常。作为常规治疗计划CT采集的一部分，从23例肺癌患者中采集了高分辨率成对吸气和呼气CT扫描。当应用于成对的CT扫描时，PRM分析基于体素将肺实质分类为正常、小气道疾病（SAD）、肺气肿或实质疾病（PD）。PRM分类量化为总肺体积的百分比，并在肺内进行全局和区域评价。RT前CT扫描的PRM分析使用产生患者特异性图和定量肺部异常的特异性表型的工作流程成功实施。通过这项研究，证实了该肺癌患者人群中SAD和PD的高患病率，全球平均值分别为10%和17%。此外，发现原发性肿瘤累及区域的PRM分类正常和SAD与总体肺值显著不同。当存在时，PD和SAD异常水平升高倾向于在肺的多个区域中普遍存在，表明基础疾病的巨大负担。肺异常，如PRM检测，其特征在于肺癌患者预定RT。虽然需要进一步的研究，PRM是一种高度可访问的CT为基础的成像技术，有可能确定局部肺异常与慢性阻塞性肺疾病和间质性肺疾病。放射肿瘤学环境中的进一步研究可能会提供基于先前存在的基于PRM的病理学定制RT计划和风险评估的策略。
Parametric response mapping (PRM) of high-resolution, paired inspiration and expiration computed tomography (CT) scans is a promising analytical imaging technique that is currently used in diagnostic applications and offers the ability to characterize and quantify certain pulmonary pathologies on a patient-specific basis. As one of the first studies to implement such a technique in the radiation oncology clinic, the goal of this work was to assess the feasibility for PRM analysis to identify pulmonary abnormalities in patients with lung cancer before radiation therapy (RT). High-resolution, paired inspiration and expiration CT scans were acquired from 23 patients with lung cancer as part of routine treatment planning CT acquisition. When applied to the paired CT scans, PRM analysis classifies lung parenchyma, on a voxel-wise basis, as normal, small airways disease (SAD), emphysema, or parenchymal disease (PD). PRM classifications were quantified as a percent of total lung volume and were evaluated globally and regionally within the lung. PRM analysis of pre-RT CT scans was successfully implemented using a workflow that produced patient-specific maps and quantified specific phenotypes of pulmonary abnormalities. Through this study, a large prevalence of SAD and PD was demonstrated in this lung cancer patient population, with global averages of 10% and 17%, respectively. Moreover, PRM-classified normal and SAD in the region with primary tumor involvement were found to be significantly different from global lung values. When present, elevated levels of PD and SAD abnormalities tended to be pervasive in multiple regions of the lung, indicating a large burden of underlying disease. Pulmonary abnormalities, as detected by PRM, were characterized in patients with lung cancer scheduled for RT. Although further study is needed, PRM is a highly accessible CT-based imaging technique that has the potential to identify local lung abnormalities associated with chronic obstructive pulmonary disease and interstitial lung disease. Further investigation in the radiation oncology setting may provide strategies for tailoring RT planning and risk assessment based on pre-existing PRM-based pathology.